scholarly journals Diagnostic Value of C-Reactive Protein in Patients with Angiographically Documented Coronary Heart Disease

2002 ◽  
Vol 45 (4) ◽  
pp. 155-160 ◽  
Author(s):  
Esin Eren ◽  
Necat Yılmaz ◽  
Sadrettin Pençe ◽  
Hasan Koçoğlu ◽  
Sıtkı Göksu ◽  
...  

Aim: The aim of this study was to evaluate the diagnostic value of serum C-reactive protein (CRP) level measurement in predicting coronary artery disease (CAD) that can be shown angiographically. Methods: CRP levels were determined in the blood of 198 patients (patients group, PG) with angiographically documented coronary artery disease and compared with that of 85 patients (control group, CG) who had a clinical indication for coronary angiography but have no angiographically determined coronary artery stenosis, as well as with that of 41 healthy volunteers as a healthy control group (HG) who did not have any complaint and did not have coronary angiography. CRP levels were measured 24 hours prior to angiography in PG and CG patients, and in the morning after not having eaten for same time. Any coronary artery stenosis or plaque formation was defined as CAD. Severity of the disease was assessed by both the number of diseased vessels (0 to 3) and the degree of stenosis (<50 % mild, 50–70 % moderate and >70 % severe). Results: Receiver Operating Characteristics (ROC) curves of CRP in angiographically documented CAD group showed a diagnostic value of 0.659 in female patients, followed by 0.542 in male patients, in predicting CAD. CRP levels were found to be significantly different between groups, higher in PG (6.2 ± 0.86 mg/L) than those of CG (3.7 ± 0.92 mg/L) and HG (0.854 ± 0.2 mg/L) (p<0.05). CRP levels were not associated with the number of diseased vessels, neither with the degree of the occlusion (p>0.05). Multiple logistic regression analysis after adjustment for the established coronary risk factors showed CRP as an independent discriminating risk factor for CAD. Conclusion: It is concluded that CRP measurement has a value in predicting the presence of angiographically documented CAD. However, CRP levels were not associated with the degree or severity of CAD.

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Yasushi Matsuzawa ◽  
Seigo Sugiyama ◽  
Hitoshi Sumida ◽  
Koichi Sugamura ◽  
Toshimitsu Nozaki ◽  
...  

Endothelial dysfunction is an important step in the atherosclerosis progression, and associates with future cardiovascular events. Reactive hyperemia peripheral arterial tonometry (RH-PAT) is a noninvasive, automatic, and objective tool to evaluate endothelial dysfunction. Angiographic complex coronary lesions are involved in plaque vulnerability. We investigated whether finger values of RH-PAT could correlate with angiographic coronary plaque complexity in patients with coronary artery disease (CAD). RH-PAT was measured using Endo-PAT2000 in 171 patients who were referred to Kumamoto University Hospital for cardiac catheterization. We defined the two group as below, Control group; coronary artery stenosis > 25% (n = 36, age 63 ± 11, male 25 %), and CAD group; coronary artery stenosis > 25 % (n = 135, age 68 ± 11, male 74 %). Coronary lesions (single-vessel; n = 29, multi-vessel disease; n = 106) were classified as of simple appearance (n = 43) or complex appearance (n = 92) by coronary angiography. Values of RH-PAT were significantly lower in patients with CAD than Control (1.65 [1.50 – 1.86] versus 1.92 [1.80 – 2.28], P < 0.01), and were significantly lower in CAD patients with complex coronary appearance than patients with simple coronary appearance (1.55 [1.45 – 1.76] versus 1.81 [1.66 – 1.95], P < 0.01). All patients underwent selective coronary angiography, and the extent of coronary stenosis was assessed using the scoring system. RH-PAT was significantly correlated with coronary plaque Extent Score (Rs = −0.33, P < 0.01). Single logistic regression analysis demonstrated that high-density lipoprotein cholesterol, triglycerides, and RH-PAT value significantly associated with the presence of complex coronary lesions, and multivariable analysis including cardiovascular risk factors identified that lower RH-PAT value was the only factor associated with the complex coronary lesions (odds ratio 1.45, 95% confidence interval 1.14 – 1.84; P < 0.01). Endothelial dysfunction was significantly associated with angiographic complex appearance of coronary plaques in patients with CAD. CAD patients with lower RH-PAT values might be vulnerable patients with vulnerable plaques and vulnerable endothelium.


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ertuğrul Kurtoğlu ◽  
Hasan Korkmaz ◽  
Erdal Aktürk ◽  
Mücahid Yılmaz ◽  
Yakup Altaş ◽  
...  

Objectives. There are limited clinical data revealing the relationship between mitral annular calcification (MAC) and systemic inflammation. The goal of the present study was to compare high-sensitivity C-reactive protein (hs-CRP) levels in patients with and without MAC and investigate the relationship between MAC and hs-CRP.Methods. One hundred patients with MAC who underwent transthoracic echocardiography (TTE) and 100 age-matched controls without MAC who underwent TTE were included in our study. Hs-CRP levels were compared between groups.Results. Prevalence of female gender, hypertension, and coronary artery disease were significantly higher in the MAC group than in the control group (64% versus 45%,P=0.007, 42% versus 28%,P=0.03and 37% versus 18%,P=0.003, resp.). On multivariate analysis, age, gender, and coronary artery disease were the only independent predictors of MAC. The levels of hs-CRP were higher in the MAC group than in the control group (2.02±0.35versus1.43±0.47 mg/dl,P<0.001). This increase in hs-CRP levels in the MAC group persisted in patients without hypertension, coronary artery disease, and in male patients when compared to the control group.Conclusions. Our study demonstrated that hs-CRP, which is a sensitive marker of systemic inflammation, increased in patients with MAC.


2021 ◽  
Vol 104 (10) ◽  
pp. 1711-1721

Background: Magnetic resonance coronary angiography (MRCA) is one of the most promising tools for noninvasive imaging of coronary arteries without radiation exposure or contrast media administration. However, knowledge about the prognostic value of MRCA is limited. Materials and Methods: The present study included 389 patients with known or suspected coronary artery disease (CAD) underwent clinical cardiac magnetic resonance (CMR) including MRCA imaging. The presence of a significant coronary artery stenosis was defined by visual estimation of ≥50% diameter reduction using targeted MRCA images. Patients were followed up for hard cardiac events (cardiac death or non-fatal myocardial infarction) and major adverse cardiac events (MACE) which also included hospitalization for heart failure and late revascularization (>180 days after the CMR study). Results: The average age was 68±11 years and 48% were male. One hundred and thirty-nine patients had significant stenosis on MRCA. During a median follow-up period of 53.9 months, 23 hard cardiac events and 52 MACE, occurred. Patients with significant coronary artery stenosis had higher rates of hard cardiac events (annual event rate 3.12% versus 0.56%, HR 5.52, 95% CI 2.17 to 14.01, p<0.001) and MACE (annual event rate 6.44% versus 1.83%, HR 3.49, 95% CI 1.98 to 6.14, p<0.001) than those without significant stenosis. Multivariable analyses identified significant coronary artery stenosis as an independent predictor of hard cardiac events (HR 3.35, 95% CI 1.13 to 9.96, p=0.03) and MACE (HR 2.00, 95% CI 1.02 to 3.90, p=0.04). MRCA presented an incremental prognostic value over clinical factors, left ventricular ejection fraction, and myocardial scarring to predict hard cardiac events (p=0.03). Conclusion: Targeted MRCA demonstrated independent and incremental prognostic values to predict future cardiac events in patients with known or suspected CAD. Keywords: Cardiac magnetic resonance imaging; Coronary artery disease; Magnetic resonance coronary angiography; Prognosis


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mohammad Hosein Mohamadi ◽  
Alireza Rai ◽  
Mansour Rezaei ◽  
Alireza Khatony

Aim. Peripheral vascular disease (PVD) and coronary artery disease (CAD) are, in many cases, asymptomatic and not usually diagnosed. The timely diagnosis of peripheral vascular diseases can act as an indicator or practical evidence of CAD. Therefore, this study was conducted to determine the relationship between interarm systolic blood pressure difference (IASBPD) and severity and number of coronary artery stenosis. Methods. The samples in this cross-sectional study consisted of 578 patients who were candidates for coronary angiography, with an average age of 57.5 ± 10.5 years. Patients were classified according to CAD and number and severity of coronary artery stenosis. The relationship between IASBPD and presence or lack of CAD as well as the number and severity of coronary artery stenosis was studied. The sensitivity, specificity, and positive predictive value of IASBPD index were calculated for the detection of CAD using the Kappa coefficient. Results. There was no statistically significant relationship between IASBPD, CAD, and severity and number of coronary artery stenosis. This index had low sensitivity and predictive value in the diagnosis of CAD and stenosis in coronary arteries in comparison with angiography. Conclusion. The results showed that the IASBPD index cannot be a valid criterion for the diagnosis of CAD as well as the number and severity of coronary artery stenosis. More studies with larger sample sizes and different designs are needed in this regard to achieve more conclusive results.


2020 ◽  
Author(s):  
Haorou Luo ◽  
Tuli Kou ◽  
Lixue Yin

Abstract Background: Lipid and inflammatory molecules play a key role in the development of coronary atherosclerosis. Hypersensitive C-reactive proteins are used as markers of inflammation duration, and HDL-C is used as an anti-atherosclerosis component. However, few studies have combined the two indicators to explore coronary stenosis. We suggested that Hypersensitive C-reactive proteins as a marker of inflammation persistence and HDL-C as an anti-atherosclerosis component should be integrated into a single biomarker , so as to explore the correlation of Hypersensitive C-reactive protein HDL-C ratio with the severity of coronary stenosis and to predict the severity of coronary stenosis in CAD patients.Methods: We examined 360 eligible patients who underwent coronary angiography. Based on the results of coronary angiography, patients with any major coronary arteries (the left anterior descending artery, the left circumflex artery, the left main coronary artery, the right coronary artery) whose lumen diameter reduced by more than 50% were defined as CAD + group (n = 139) .Patients with luminal stenosis but no more than 50% were defined as CAD- group (n = 41), and patients without luminal stenosis (n = 180) were regarded as control group. The relationship between various serum markers and the severity of coronary stenosis was examined by Spearman correlation analysis. Logistic regression analysis was performed to identify the influencing factors of the severity of coronary artery disease.Results: The modified Gensini score was positively correlated with Hypersensitive C-reactive protein HDL-C ratio . Multiple regression analysis showed that Hypersensitive C-reactive protein HDL-C ratio were significantly associated with CAD. Hypersensitive C-reactive protein HDL-C ratio is an independent predictor of CAD. The ROC analysis provided a cut-off value of 1.17 for Hypersensitive C-reactive protein HDL-C ratio to predict CAD with 83.9% specificity and 0.242 Yoden index, and area under the ROC curve of 0.632 (95%CI 0.571-0.694, P <0.001).At the same time, the area under the ROC curve of Neutrophil HDL-C ratio was 0.620, indicating that Hypersensitive C-reactive protein HDL-C ratio as a predictor of CAD has better diagnostic performance than Neutrophil HDL-C ratio.Conclusion: Hypersensitive C-reactive protein HDL-C ratio is not only closely related to coronary artery stenosis, but also an independent predictor of severe coronary stenosis.


2019 ◽  
Vol 18 (2) ◽  
pp. 379-384
Author(s):  
Taufik Indrajaya ◽  
Yudhi Fadilah ◽  
Mediarty Yuwono ◽  
Ali Ghanie

Background: Now a days coronary artery disease (CAD) becomes major cause of death. One among 7 deaths in America caused by CAD. CAD is an atherosclerosis process, which progresively develops into plaque that will lead to stenosis of coronary artery lumen. Several studies found that high serum fibrinogen level is an independent and significant to the severity of artery coronary stenosis. Serum fibrinogen level determined by genetic factor. Polymorphism of fibrinogen gene β -455 G/A seem plays an important role in plasma fibrinogen level. Although some studies showed a significant correlation between polymorphism and cardiovascular diseases, but some other studies report inversely. Aim. To evaluate the correlation between the polymorphism of fibrinogen gene β -455 G/A and serum fibrinogen level with the severity of artery coronary stenosis. Method: This is an analytic correlative study with prospective approach without comparison. Coronary angiography was performed in catheterization labor in the department of internal medicine, while DNA analysis and PCR done in the department of microbiology in General Hospital dr Muhammad Husin Palembang- Indonesioa, since July 2015 until Agustus 2016. Samples are CAD patient who undergo for coronary angiography and fulfield the criterias. The severity of stenosis in coronary artery determined by Gensini score. This study included 31 patient. Results. Among 31 CAD patients, this study found severe stenosis of coronary artery in 17 patients (53,1%), moderate in 5 patients (15,6%) and mild in 10 patients (31,2%). Genetic analysis showed that serum fibrinogen level was controlled by polymorphism of fibrinogen gene β -455 G/A, concecutively by genotipe AA in 15 patients (48,4%), genotipe GA in 12 patient (38,7%) and by genotipe GG in 4 patients (12,9%). Chi Square test showed a significant correlation between polymorphism gene fibrinogen β -455 G/A and serum fibrinogen level (p=0,039). Spearman’s rho test found no significant correlation between serum fibrinogen level and severity of coronary artery stenosis based on Gensini score (r=0,142; p=0,447). And also this study found no significant correlation between polymorphism gene fibrinogen β -455 G/A with the severity of stenosis in coronary artery (p=0,512). Conclusion. Although this study succeded to prove that serum fibrinogen level was determined by polymorphism fibrinogen gene β -455 G/A, but there are no significant correlations between polymorphism fibrinogen gene β -455 G/A and serum fibrinogen level with severity of coronary artery stenosis in CAD patients. This study suggest to study other candidate gene to look for other cardiac risk beside this fibrinogen. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.379-384


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Meijuan Liu ◽  
Zeyu Liu ◽  
Huijuan Zhu ◽  
Linjie Wang ◽  
Hongbo Yang ◽  
...  

Coronary artery disease (CAD), the leading cause of morbidity and mortality, has imposed huge health and economic burdens globally. Zinc-α2-glycoprotein (ZAG) is a novel adipokine. Increasing evidence suggests the close relationship between serum ZAG levels and various cardiometabolic risk factors. However, the relationship between serum ZAG levels and CAD is still not fully clarified. We conducted this study to evaluate serum ZAG levels and its association with cardiovascular risk factors. A total of 129 patients with CAD, 99 patients with noncoronary artery disease (NCAD), and 121 controls were recruited in this retrospective study. CAD (coronary artery stenosis ≥50%) or NCAD (coronary artery stenosis <50%) patients who underwent coronary angiography were diagnosed according to the American Heart Association criteria. Serum ZAG levels were determined via commercial enzyme-linked immunosorbent assay (ELISA) kits. The results showed that serum ZAG levels in CAD and NCAD groups were significantly decreased when compared with those in the control group. Multiple stepwise regression analysis revealed that the grouping variable (control, NCAD, and CAD) was an independent determinant of serum ZAG levels (β = −0.328, P<0.001) after controlling other confounding factors. Further multivariate ordinary logistic regression analysis demonstrated that the risk of grouping at one level higher in subjects with the lowest tertile of ZAG levels was 2.28-fold higher than those with the highest tertile levels (OR = 3.281, 95% CI 1.782–6.038, P<0.001). The receiver-operating characteristic (ROC) curve analysis showed that serum ZAG could distinguish CAD patients (AUC = 0.706, 95% CI, 0.643–0.770, P<0.05), NCAD patients (AUC = 0.673, 95% CI, 0.602–0.743, P<0.05), and NCAD and CAD patients (AUC = 0.692, 95% CI, 0.633–0.750, P<0.05) from controls. In conclusion, serum ZAG levels were significantly decreased in NCAD/CAD patients. The decreased serum ZAG levels were independently associated with the presence of NCAD/CAD. ZAG might serve as a candidate diagnostic biomarker for NCAD/CAD.


Sign in / Sign up

Export Citation Format

Share Document