The role of high-sensitive C-reactive protein in patients undergoing elective coronary angiography

BACKGROUND: The link between inflammation and cardiovascular disease is well-established. High-sensitive C-reactive protein (hs-CRP) is the most extensively studied biomarker, even though the association between hs-CRP and atherosclerotic coronary artery disease remains a topic of debate. We aimed to analyze the role of hs-CRP risk stratification to chronic coronary artery disease (CAD) and/or other cardiac disorders in patients undergoing elective coronary angiography (ECA).METHODS: This was a prospective cross-sectional study conducted on 114 consecutive patients that underwent ECA. Patients were divided into three groups according to the level of hs-CRP (low risk <1 mg/L [26 patients]; intermediate risk 1-3 mg/L [48 patients]; high risk > 3 mg/L [40 patients]).RESULTS: The mean level of hs-CRP was 3.94±6.23 mg/L, whereas mean values among the three risk groups were 0.62±0.26 mg/L, 1.79±0.62 mg/L and 8.69±8.71 mg/L, respectively. The three hs-CRP risk groups differed among them in regard to Body Mass Index (BMI) (26.53±4.1 kg/m2 vs. 27.37±3.7 kg/m2 vs. 29.64±4.5 kg/m2, P=0.005), platelet count (205.4±72.6×109/L vs. 248.1±61.7×109/L vs. 239.3±60.9×109/L, P=0.02), blood glucose level (5.89±2 mmo/L vs. 6.7±2.4 mmol/L vs. 7.5±3.1 mmol/L, P=0.049), echocardiography parameter E/A (1.0±0.3 vs. 0.85±0.2 vs. 0.83±0.3, P=0.008), e´ septal (7.9±2.1 cm/s vs. 6.7±2.1 cm/s vs. 6.6±1.7 cm/s, P=0.02), e´ lateral (10.1±3.4 cm/s vs. 9.1±2.6 cm/s vs. 8.3±2.3 cm/s, P=0.03) and non-invasively measured pulmonary artery systolic pressure (PASP) (23.4±9.3 mmHg vs. 25.5±6.5 mmHg vs. 30±7.7 mmHg, P=0.002).CONCLUSIONS: Chronic CAD does not appear to be associated with elevated hs-CRP levels. Nonetheless, patients undergoing ECA may exhibit higher hs-CRP levels if they have increased BMI, platelet count, blood glucose levels, PASP, and left ventricular diastolic dysfunction.