hs-CRP as a predictive factor for cardiac outcome

The Editor, I read the report on evaluation on high-sensitivity C-reactive protein (hs-CRP) by Balciunus et al., with a great interest.[1] Balciunus et al., reported that preoperative inflammatory state, as measured by hs-CRP, is an important determinant of postoperative outcome after coronary artery bypass graft (CABG) surgery.[1] I agree with the Balciunus et al., that hs-CRP has predictive value of scores in cardiac surgery. Indeed, this finding is correct and can be predicted. In laboratory medicine, hs-CRP is accepted as a good laboratory test for cardiac pathology,[2] not only for the scenario of postcardiac surgery; basically, CRP is useful in predicting early, intermediate-term, and long-term mortality and major adverse cardiac events in patients undergoing vascular surgeries. The new generation of the test, with higher sensitivity, hs-CRP has a more usefulness in this purpose.[3] Low et al., recently said that “hs-CRP is useful in further stratifying high-risk multi-ethnic patients presenting with chest pain despite no evidence of myocardial infarction”.[3] In addition, Ucar et al., noted that hs-CRP has a good utility in prediction of atrial fibrillation after bypass surgery.[4] However, the difference in hs-CRP levels before the bypass grafting surgery due to the difference underlying pathological conditions should be mentioned. The recent study by Shakouri et al., showed that the patients undergoing cardiac bypass surgery with common carotid artery stenosis had higher levels of serum hs-CRP than patients without stenosis.[5]