C-REACTIVE PROTEIN AND ITS ROLE IN DIAGNOSIS, MYOCARDIAL DAMAGE, AND ANGIOGRAPHIC FINDINGS IN PATIENTS WITH ACUTE CORONARY SYNDROME
Main Article Content
Keywords
C-reactive protein, acute coronary syndrome, myocardial infarction, inflammation, prognosis, angiography
Abstract
Background and Objective
C-reactive protein (CRP), a key acute-phase reactant, is known to reflect systemic and vascular inflammation and has been implicated in the pathogenesis of atherosclerotic plaque instability. This study aimed to evaluate the prognostic utility of CRP levels in diagnosing myocardial injury and predicting angiographic and clinical outcomes in patients presenting with acute coronary syndrome (ACS).
Methods
This prospective, single-center study was conducted in the Department of Cardiology in collaboration with the Department of Pathology at Army Cardia Hospital Lahore, from 1st January 2023 till 31st December 2023. A total of 200 patients presenting with chest pain were enrolled and categorized into four groups: Group 1 (unstable angina), Group 2 (ST-elevation myocardial infarction, STEMI), Group 3 (non-ST-elevation myocardial infarction, NSTEMI), and Group 4 (control group with non-cardiac chest pain). High-sensitivity CRP (hs-CRP) levels were measured at admission. All patients were followed for 90 days for major adverse cardiac events including myocardial infarction, heart failure, and cardiac death.
Results
CRP levels were significantly higher in STEMI and NSTEMI groups compared to those with unstable angina and the control group (p < 0.00001). The mean CRP level across all patients was 17.6 ± 7.96 mg/L (95% CI: 1.66–33.6). Elevated CRP (>3.0 mg/L) was associated with a significantly higher incidence of cardiac events during the follow-up period, particularly in Groups 2 and 3. The highest incidence of death, myocardial infarction, and heart failure occurred among patients with elevated CRP in the STEMI and NSTEMI groups.
Conclusion
Measurement of CRP upon admission in patients with suspected ACS provides valuable prognostic information. Elevated CRP identifies individuals at increased risk of adverse cardiovascular events, underscoring the need for aggressive management and close post-discharge surveillance.
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Atif Nadeem
Department of Cardiology, Army Cardiac Hospital, Lahore, Pakistan
Mian Muhammad Umair Siddique
Department of Cardiology, Army Cardiac Hospital, Lahore, Pakistan
Bader Javed
Department of Cardiology, Army Cardiac Hospital, Lahore, Pakistan
Hafiz Mian Muhammad Farhan Siddique
Department of Cardiology, Army Cardiac Hospital, Lahore, Pakistan
Ahmed Usman
Department of Cardiology, Army Cardiac Hospital, Lahore, Pakistan
Aqib Ishaque
Department of Cardiology, Army Cardiac Hospital, Lahore, Pakistan