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. 2008 Sep 9;31(9):437–442. doi: 10.1002/clc.20267

Value of Serial C‐reactive Protein Measurements in Non ST‐segment Elevation Acute Coronary Syndromes

Masami Kosuge 1, Toshiaki Ebina 1, Kiyoshi Hibi 1, Toshiyuki Ishikawa 1, Mitsuaki Endo 1, Takayuki Mitsuhashi 1, Katsutaka Hashiba 1, Satoshi Umemura 1, Kazuo Kimura 1,✉
PMCID: PMC6652822  PMID: 18781604

Abstract

Background

Elevated C‐reactive protein (CRP) levels at admission are associated with adverse outcomes in patients with non ST‐segment elevation acute coronary syndromes (NSTE‐ACS).

Hypothesis

C‐reactive protein measurement not only at admission, but also after admission, may be useful for predicting adverse outcomes in NSTE‐ACS.

Methods

We measured high‐sensitivity CRP levels at admission and at 24 h in 215 patients with NSTE‐ACS. An elevated CRP level at admission (admission elevation) was defined as a CRP level of ≥ 0.300 mg/dL. An increase in the CRP level after admission (increase at 24 h) was considered present when the CRP level at 24 h was higher than the level at admission. Patients were divided into 4 groups according to the presence or absence of admission elevation and increase at 24 h. Coronary angiography was performed at a mean of 3 d after admission.

Results

There were no significant differences among the 4 groups in age, sex, coronary risk factors, or multivessel disease. Patients with both admission elevation and increase at 24 h had higher rates of ST‐segment depression and positive troponin T at admission. Multivariate analysis showed that admission elevation (odds ratio [OR] 1.50, p < 0.05) and increase at 24 h (OR 6.56, p = 0.03) were independent predictors of 30‐d events (e.g., death, myocardial infarction, or refractory angina). The highest risk of 30‐d events was associated with both admission elevation and increase at 24 h.

Conclusions

Serial CRP measurements are useful for predicting the risk of subsequent ischemic complications in patients with NSTE‐ACS. Copyright © 2008 Wiley Periodicals, Inc.

Keywords: acute coronary syndromes, inflammation, prognosis

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