The antiplatelet effect of atorvastatin in patients with acute coronary syndrome depends on the hs-CRP level

Abstract BACKGROUND There are conflicting data on whether changes in N-terminal pro–B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) concentrations between time points (delta NT-proBNP and hs-CRP) are associated with a change in prognosis. METHODS We measured NT-proBNP and hs-CRP at 3 time points in 1665 patients with non–ST-segment elevation acute coronary syndrome (NSTEACS). Cox proportional hazards was applied to the delta between temporal measurements to determine the continuous association with cardiovascular events. Effect estimates for delta NT-proBNP and hs-CRP are presented per 40% increase as the basic unit of temporal change. RESULTS Median NT-proBNP was 370.0 (25th, 75th percentiles, 130.0, 996.0), 340.0 (135.0, 875.0), and 267.0 (111.0, 684.0) ng/L; and median hs-CRP was 4.6 (1.7, 13.1), 1.9 (0.8, 4.5), and 1.8 (0.8, 4.4) mg/L at baseline, 30 days, and 6 months, respectively. The deltas between baseline and 6 months were the most prognostically informative. Every +40% increase of delta NT-proBNP (baseline to 6 months) was associated with a 14% greater risk of cardiovascular death (adjusted hazard ratio (HR) 1.14, 95% CI, 1.03–1.27) and with a 14% greater risk of all-cause death (adjusted HR 1.14, 95% CI, 1.04–1.26), while every +40% increase of delta hs-CRP (baseline to 6 months) was associated with a 9% greater risk of the composite end point (adjusted HR 1.09, 95% CI, 1.02–1.17) and a 10% greater risk of myocardial infarction (adjusted HR 1.10, 95%, CI 1.00–1.20). CONCLUSIONS Temporal changes in NT-proBNP and hs-CRP are quantitatively associated with future cardiovascular events, supporting their role in dynamic risk stratification of NSTEACS. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier NCT00699998

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Association between increase level of high-sensitive CRP (hs CRP) and non-arrhythmic ECG changes and echocardiographic abnormalities in patients with acute coronary syndrome

10.22541/au.158920727.71297994 ◽

2020 ◽

Author(s):

asghar rahmani ◽

roholla hemmati ◽

Seyed Hossein Kia

Keyword(s):

Acute Coronary Syndrome ◽

Ecg Changes ◽

Coronary Syndrome ◽

Hs Crp

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Variability of prasugrel antiplatelet effect in patients with acute coronary syndrome

Medical Research Journal ◽

10.5603/fmc.2015.0006 ◽

2015 ◽

Vol 3 (3) ◽

pp. 117-124

Author(s):

Michał Kasprzak ◽

Małgorzata Molska ◽

Karolina Obońska ◽

Emilia Kolasińska ◽

Julia Maria Kubica ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Antiplatelet Effect ◽

Coronary Syndrome

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741 The relationship between the left ventricular systolic functions and hs-CRP levels in patients with acute coronary syndrome

European Journal of Heart Failure Supplements ◽

10.1016/s1567-4215(03)90479-6 ◽

2003 ◽

Vol 2 (1) ◽

pp. 158

Author(s):

K SONMEZ

Keyword(s):

Acute Coronary Syndrome ◽

Left Ventricular ◽

Coronary Syndrome ◽

Hs Crp ◽

The Relationship

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The Association between hs-CRP Levels with GRACE Score in Acute Coronary Syndrome Patients in H. Adam Malik Medan Central General Hospital

International Journal of Research and Review ◽

10.52403/ijrr.20210831 ◽

2021 ◽

Vol 8 (8) ◽

pp. 220-226

Author(s):

Putri Gaby Yosephine ◽

Refli Hasan ◽

Rahmad Isnanta

Keyword(s):

Acute Coronary Syndrome ◽

General Hospital ◽

Spearman Correlation ◽

Correlation Test ◽

Coronary Syndrome ◽

Wide Range ◽

Significant Difference ◽

Spearman Correlation Test ◽

Hs Crp ◽

Grace Score

Objective: Acute coronary syndrome (ACS) describes a wide range of myocardial ischemia, which is always associated with the rupture of atherosclerotic plaques in coronary arteries. CRP has been shown to be a risk predictor of ACS. GRACE score has been associated with predicting early and late death in ACS patients. Therefore, this study aim to investigate the association between high sensitivity C-reactive protein (hs-CRP) levels with GRACE score in ACS patients. Methods: This study was a retrospective analytic study. The study population was acute coronary syndrome patients in central general hospital of H. Adam Malik, Medan city and 51 patients who met the inclusion and exclusion criteria. Data analysis was calculated using univariate and bivariate analysis. A correlation test was carried out using Spearman correlation test to determine the association between hs-CRP levels with GRACE score in ACS patients. Results: There were 51 samples included in the study. There was a significant difference (p = 0.005) in the mean hs-CRP levels in UAP, NSTEMI, and STEMI subjects. In contrast, there was no significant difference in GRACE score among the three ACS diagnoses. For the association of hs-CRP levels with GRACE score in all subjects, the Spearman correlation test showed a significant correlation between hs-CRP levels with GRACE score (p < 0.001) with a correlation coefficient (r) of 0.588. Conclusion: There was a significant association between serum hs-CRP levels with GRACE score and the higher hs-CRP levels, followed by a higher GRACE score. Keywords: Acute coronary syndrome, GRACE score, hs-CRP.

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