Abstract
Background: There is growing evidence that C‐reactive protein (CRP) may have a direct role in the pathogenesis of atherosclerosis.
Hypothesis: The purpose of this study was to assess associations between CRP and adhesion molecules and to determine the prognostic value of adhesion molecules as a predictor of cardiac events in patients with unstable angina.
Methods: Fifty‐five consecutive patients (33 males, mean age 61 years) with unstable angina (Braunwald class IIb or Ib) undergoing coronary stenting were included in this study.
Results: The test for a trend toward increasing intercellular adhesion molecule (ICAM)‐1 concentrations by the 75th percentile of CRP levels at 72 h after coronary stenting was significant (p = 0.03). At 72 h after coronary stenting, CRP levels were the only determinants of ICAM‐1 concentrations by multiple linear regression analysis. An elevated level of CRP (>5.4mg/l) (oddsratio [OR] 1.5,95%confidenceinterval [CI] 1.3–3.7, p<0.05) and ICAM‐1 (>321 ng/ml) (OR 1.2, 95% CI 1.1–2.1, p < 0.05) at 72 h after coronary stenting is an independent risk factor for an adverse cardiac event.
Conclusions: These results suggest that in patients with unstable angina undergoing coronary stenting, the measurements of inflammatory parameters, especially CRP and ICAM‐1, may be useful for identifying those at higher risk of a cardiac event, and CRP may play a direct role in promoting the inflammatory component of atherosclerosis by inducing significant expression of ICAM‐1.
Keywords: unstable angina, C‐reactive protein, adhesion molecules
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