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Year : 2012  |  Volume : 13  |  Issue : 1  |  Page : 7-12

C-reactive protein as a predictor of adverse outcome in patients with acute coronary syndrome

1 Department of Cardiology, Southend University Hospital NHS Foundation Trust, Essex, United Kingdom
2 Department of Obstetrics and Gynecology, Royal Free Hampstead NHS Trust, London, United Kingdom
3 Department of Hematology and Transfusion Medicine, Bolan Medical College Complex, Quetta, Balochistan, Pakistan
4 Department of Gastroenterology, Shaikh Zayed Hospital, Lahore, Pakistan

Correspondence Address:
A S Sheikh
Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Essex, , SS0 0RY
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1995-705X.96660

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Background and Objectives: The acute-phase reactant C-reactive protein (CRP) has been shown to reflect systemic and vascular inflammation and to predict future cardiovascular events. The objective of this study was to evaluate the prognostic value of CRP in predicting cardiovascular outcome in patients presenting with acute coronary syndromes. Patients and Methods: This prospective, single-centered study was carried out by the Department of Pathology in collaboration with the Department of Cardiology, Bolan Medical College Complex Quetta, Balochistan, Pakistan from January 2009 to December 2009. We studied 963 consecutive patients presenting with chest pain to Accident and Emergency Department. Patients were divided into four groups. Group-1 comprised patients with unstable angina; group-2 included patients with acute ST elevation myocardial infarction (STEMI); group-3 comprised patients with Non-ST elevation myocardial infarction (Non-STEMI) and group-4 was the control group. All four groups were followed-up for 90 days for occurrence of cardiovascular events. Results: The CRP was elevated (>3 mg/L) among 27.6% patients in Group-1; 70.9% in group- 2; 77.9% in group-3 and 5.3% in the control group. Among cases with elevated CRP, 92.1% had a cardiac event compared to 34.3% among patients with CRP £3 mg/L (P < 0.0001). The mortality was significantly higher (P < 0.0001) in group-2 (8.9%) and group-3 (11.9%) as compared to group-1 (2.1%). There was no cardiac event or mortality in Group-4. Conclusions: Elevated CRP is a predictor of adverse outcome in patients with acute coronary syndromes and helps in identifying patients who may be at risk of cardiovascular complications.

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