Key result
High-sensitive C-reactive protein levels were significantly elevated in coronary heart disease patients with diabetes (6.0 mg/L) and without diabetes (3.7 mg/L) compared to healthy controls (0.7 mg/L).
Why the study?
Traditional risk factors alone do not explain the excess incidence of coronary heart disease in India, and existing data show inconsistency regarding risk prediction by Lp(a) and hs-CRP.
Are levels of Lipoprotein (a) and hs-CRP elevated in patients with coronary heart disease compared to healthy controls?
Case-Control (n=120)
No
Are levels of Lipoprotein (a) and hs-CRP elevated in patients with coronary heart disease compared to healthy controls?
Absolute Event Rate: 6% vs 0.7%
p-value: p=<0.001
High-sensitive C-reactive protein (hs-CRP) is a more consistent and independent inflammatory marker than Lipoprotein (a) for coronary heart disease, regardless of the patient's diabetic status.
Background: The incidence of ischemic heart disease/ myocardial infarction is rapidly increasing in India. However, the traditional risk factors alone could not explain this excess of Coronary Heart Disease (CHD). So, we are in need of a tool to assess the severity and prognosis of these acute coronary syndromes. Lipoprotein (a) [Lp(a)] and High Sensitive C-Reactive Protein (hs-CRP) have been recognised as independent risk factors for CHD in many retrospective case control studies. As the data shows inconsistency in the prediction of risk by Lp(a) and hs-CRP, the study is carried out to compare and correlate the levels of Lp(a) and hs-CRP in coronary heart disease patients with controls.Methods: An observational case control study was conducted at Maharaja’s Institute of Medical Sciences, Nellimarla, with 120 participants. 80 admitted with CHD were categorised as type 2 diabetic and non-diabetic. Remaining 40 participants were age matched controls, who have attended the OP for general health check-up. Samples collected from the participants were analysed for Lp(a), hs-CRP and HbA1c.Results: Lp(a) levels were significantly elevated in CHD patients with diabetes (69.2±27.5) and non-significant in CHD patients without diabetes (50.4±24.3) as compared to their controls (36.6±22.5). There was significant correlation and elevation of hs-CRP in CHD patients with diabetes (6.0±2.6) and without diabetes (3.7±2.0) as compared to their controls (0.7±0.4).Conclusions: The present study shows a lack of association of Lp(a) levels in CHD patients with and without diabetes. A strong correlation of the inflammatory marker, hs-CRP was observed between the CHD patients with and without diabetes and even as compared to their controls. It may be concluded that hs-CRP is a better and independent marker than Lp(a) in patients with CHD.
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Behera et al. (2019) conducted a case-control in Coronary heart disease (n=120). Coronary heart disease vs. Age-matched healthy controls was evaluated on High sensitive C-reactive protein (hs-CRP) levels (mg/L) in CHD patients with diabetes (p=<0.001). High-sensitive C-reactive protein levels were significantly elevated in coronary heart disease patients with diabetes (6.0 mg/L) and without diabetes (3.7 mg/L) compared to healthy controls (0.7 mg/L).
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