Key result
High levels of hsCRP or serum fibrinogen at admission were associated with a 96% rate of unfavourable in-hospital outcomes compared to 0% in patients with low levels.
Why the study?
Do elevated levels of high sensitivity C-reactive protein and serum fibrinogen predict adverse in-hospital outcomes in patients with unstable angina without other high-risk factors?
Observational (n=100)
No
Do elevated levels of high sensitivity C-reactive protein and serum fibrinogen predict adverse in-hospital outcomes in patients with unstable angina without other high-risk factors?
Elevated high sensitivity C-reactive protein and serum fibrinogen levels at admission are independent prognostic markers for adverse short-term in-hospital outcomes in patients with unstable angina.
Answers are grounded in this paper and cite their sources.
Should not yet change unstable angina management; hypothesis-generating for inflammatory markers in short-term risk stratification.
Introduction: Patients with unstable angina are heterogeneous in terms of risk of cardiac death and nonfatal ischemic events. Assessment of the prognosis in these individuals guides the management protocol. C -reactive protein (CRP) and serum fibrinogen are established prognostic markers in UA. Aim: This study assessed the prognostic role of high sensitivity CRP (hs CRP) and serum fibrinogen levels in unstable angina patients in eastern India with no other high risk factors. Material and methods: It was a prospective single centre observational study which included patients admitted with diagnosis of unstable angina in medical ICU from August 1, 2009 to June 1, 2011. Cases with concomitant inflammatory or neoplastic condition, valvular heart disease, left ventricular (LV) failure, ST elevation/ new or presumably new ST depression and T wave inversion in ECG, elevated cardiac biomarkers (CPK MB/ Troponin T), LV dysfunction (LVEF<50%), suspected pulmonary thrombo embolism, age>60 years, known case of coronary artery disease, heart failure, diabetes, hypertension, dyslipidemia and chronic kidney disease were excluded from the study. Patients were observed for 72 hours in medical ICU. Serum fibrinogen and high sensitivity C -reactive protein (hs CRP) levels were estimated at the time of admission, and at the end of 48 hours and 72 hours. Primary endpoints were death, myocardial infarction, heart failure and secondary endpoints were hemodynamically unstable ventricular arrhythmias, and refractory angina or recurrent angina. Patients who met the study endpoints were grouped as unfavourable group and others as favourable group.
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Kumari Priti (2018) conducted an observational in Unstable angina (n=100). High inflammatory markers (hsCRP >3 mg/L or serum fibrinogen >600 mg/dl) vs. Low inflammatory markers (hsCRP <1 mg/L and serum fibrinogen ≤500 mg/dl) was evaluated on Unfavourable outcome (composite of death, myocardial infarction, heart failure, ventricular arrhythmias, or refractory/recurrent angina) (p=<0.0001). High levels of hsCRP or serum fibrinogen at admission were associated with a 96% rate of unfavourable in-hospital outcomes compared to 0% in patients with low levels.
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