Transient myocardial ischemia did not increase plasma CRP concentrations over 96 hours in patients with unstable or variant angina, despite a higher ischemic burden in variant angina (P<0.001).
Observational (n=68)
Does transient myocardial ischemia induce an acute-phase CRP response in patients with unstable or variant angina?
Transient myocardial ischemia does not stimulate an appreciable acute-phase CRP response, indicating that elevated CRP in unstable angina is not merely a consequence of ischemic injury.
BACKGROUND: Elevated levels of C-reactive protein (CRP) are associated with an unfavorable clinical outcome in patients with unstable angina. To determine whether ischemia-reperfusion injury causes this acute-phase response, we studied the temporal relation between plasma levels of CRP and ischemic episodes in 48 patients with unstable angina and 20 control patients with active variant angina, in which severe myocardial ischemia is caused by occlusive coronary artery spasm. METHODS AND RESULTS: Blood samples were taken on admission and subsequently at 24, 48, 72, and 96 hours. All patients underwent Holter monitoring for the first 24 hours and remained in the coronary care unit under ECG monitoring until completion of the study. On admission, CRP was significantly higher in unstable angina than in variant angina patients (P 10 minutes. CONCLUSIONS: The normal levels of CRP in variant angina, despite a significantly larger number of ischemic episodes and greater total ischemic burden, and the failure of CRP values to increase in unstable angina indicate that transient myocardial ischemia, within the range of duration observed, does not itself stimulate an appreciable acute-phase response.
Liuzzo et al. (1996) conducted an observational in Unstable angina and variant angina (n=68). Unstable angina vs. Variant angina was evaluated on Change in plasma concentration of C-reactive protein (CRP) over 96 hours. Transient myocardial ischemia did not increase plasma CRP concentrations over 96 hours in patients with unstable or variant angina, despite a higher ischemic burden in variant angina (P<0.001).