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1
Department of Cardiology and
2
Central Laboratories, Athens Euroclinic, Athens 11521, Greece.
3
Department of Cardiology, St. Thomas’ Hospital, London
SE1 7EH, United Kingdom.
4
Clinical and Molecular Epidemiology Unit, Department of
Hygiene and Epidemiology, University of Ioannina, School of Medicine,
Ioannina 45110, Greece.
5
Department of Medicine, Tufts University, School of
Medicine, Boston, MA 02111.
aAddress correspondence to this author at: Central Laboratories, Athens Euroclinic, 9 Athanassiadou St., Athens 11521, Greece. Fax 30-1-6416555; e-mail haliassos{at}moleculardiagnostics.gr.
Background: C-Reactive protein (CRP) is a strong predictor of clinical outcome in coronary artery disease (CAD), and inflammation has been implicated in the process. We aimed to evaluate whether CRP concentrations measured with a new, automated particle-enhanced immunoturbidimetric method for high-sensitivity CRP may be related to specific high-risk angiographic features of coronary lesions.
Methods: In a cross-sectional study, we examined 103 consecutive patients undergoing cardiac catheterization for suspected CAD. We assessed the association of preprocedural CRP concentrations with clinical presentation (unstable angina) and angiographic features of coronary lesions.
Results: Twenty patients had unstable angina. Independent predictors of unstable angina included increased CRP [odds ratio (OR), 2.93 per 10-fold increase in CRP; 95% confidence interval (CI), 1.28–6.69; P = 0.01] and the presence of macroscopic thrombus (OR, 7.08; 95% CI, 1.33–37.8; P = 0.02). Thirty-two culprit lesions had macroscopic thrombus or eccentric/irregular discrete morphology without total occlusion. Increased CRP was the strongest predictor of such features (OR, 2.04 per 10-fold increase in CRP; 95% CI, 1.03–4.04; P = 0.04), and the effect was independent of the presence of unstable angina.
Conclusions: Among patients with suspected CAD undergoing coronary angiography, increased CRP is strongly associated with unstable angina and with specific high-risk features of the culprit coronary lesions.
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