A baseline CRP >3.5 mg/L was strongly associated with an increased risk of subsequent acute coronary events (RR 7.6; 95% CI 2.6-21.7; P=0.0002).
Cohort (n=150)
Does an inflammatory biological profile predict recurrent acute coronary events in patients with coronary artery disease?
An inflammatory biological profile, specifically elevated CRP, distinguishes patients with recurrent acute coronary events from those with stable angina and strongly predicts future acute coronary instability.
Relative Risk: 7.6 (95% CI 2.6–21.7)
valor p: p=0.0002
BACKGROUND: At one end of the clinical spectrum of coronary artery disease (CAD) are subjects who have had repeated acute ischemic events, and at the other end are those with long-standing angina who have never been unstable. This study tests the hypothesis that a specific biological profile can distinguish these 2 extreme groups and predict acute coronary events. METHODS AND RESULTS: Blood levels of lipoprotein(a), homocysteine, tissue plasminogen activator, plasminogen activator inhibitor-1, C-reactive protein (CRP), fibrinogen, and von Willebrand factor were compared in 3 groups of 50 subjects each: (1) those with previous multiple acute coronary events, (2) age-matched subjects with >/=3 years of stable angina and no prior acute coronary events, and (3) matched controls without evidence of atherosclerotic disease and a normal coronary angiogram. All subjects were followed for 4.0 years. Lipoprotein(a), homocysteine, tissue plasminogen activator, and plasminogen activator inhibitor-1 were similar in both CAD groups and significantly higher than in the control group. However, compared with subjects with long-standing stable angina, those with previous multiple coronary events had higher values of CRP (5.7+/-5.4 versus 3.0+/-5.2 mg/L, P=0.012), fibrinogen (3.38+/-0.75 versus 2.92+/-0.64 g/L, P=0.001), and von Willebrand factor (1.60+/-0.55 versus 1.25+/-0.36 U/mL, P=0.0003). On follow-up, myocardial infarction and unstable angina occurred in 42% of the group with multiple events, 4% of the stable angina group (P3.5 mg/L had a relative risk of 7.6 (2.6 to 21.7, P=0.0002) for subsequent acute events. CONCLUSIONS: An inflammatory biological profile distinguished patients with previous multiple acute coronary events from those with long-standing stable angina and predicted acute coronary instability.
Bogaty et al. (2001) conducted a cohort in Coronary artery disease (n=150). Elevated baseline CRP (>3.5 mg/L) vs. Baseline CRP ≤3.5 mg/L was evaluated on Subsequent acute coronary events (RR 7.6, 95% CI 2.6-21.7, p=0.0002). A baseline CRP >3.5 mg/L was strongly associated with an increased risk of subsequent acute coronary events (RR 7.6; 95% CI 2.6-21.7; P=0.0002).