scholarly journals High Sensitivity C-reactive Protein in Patients with Coronary Artery in-stent Restenosis: A Case-control Study

2021 ◽  
Vol 15 (1) ◽  
pp. 29-37
Author(s):  
Hussein M. Ismail ◽  
Ahmed O. Abaza ◽  
Gamela M. Nasr ◽  
Hesham Hegazy

Background: Inflammation plays a pivotal role in the pathogenesis of In-Stent Restenosis (ISR). High sensitivity C-reactive protein (hsCRP) is positively associated with major cardiovascular events. Aim: We aimed to investigate the hsCRP inflammatory response to Percutaneous Coronary Intervention (PCI) in Coronary Artery Disease (CAD) patients with coronary ISR vs. patients without ISR. Methods: This case-control study included 80 CAD patients previously treated with drug-eluting stent (DES) implantation. Patients had Coronary Angiography (CAG) because of chest pain or equivalent symptoms and were subdivided into 2 groups. Group A (n=40) included CAD patients with ISR. Group B (n=40) included age and gender-matched controls with CAD but without ISR. Serum hsCRP levels were obtained before PCI (baseline) and 8, 16, 24 h post-PCI. Results: At baseline (before intervention/CAG), the hsCRP level was increased in the ISR group compared with the No-ISR group (p=0.007). There were 36 (90%) patients in the ISR group who had a high hsCRP (>3 mg/L) compared with 25 (62.5%) patients in the No-ISR group. Also, there was a significant relationship between high hsCRP and the ISR. Patients with ISR had higher frequencies and percentages of elevated CRP than the no-ISR control group. This difference was maintained for all measurements, baseline, after 8, 16, and 24 h (p<0.05). Repeated measures analysis of variance (ANOVA) in the ISR group revealed that mean hsCRP differed significantly between serial measurements (p<0.001). In contrast, in the control group, the mean hsCRP did not differ significantly between the serial measurements (p=0.65). Most of our patients (n=66, 82.5%) had 1-vessel CAD disease, and the left anterior descending (LAD) coronary artery was significantly affected in 46 patients (57.5%). Management of restenosis was accomplished mainly by stenting by DES in 29 patients (72.5%). Conclusion: Patients with ISR had substantially higher pre- and post-PCI hsCRP levels than the no-ISR controls. This difference was maintained up to 24h post-PCI. Conversely, the mean hsCRP did not significantly differ at the follow-up points for the controls without ISR.

2017 ◽  
Vol 31 (2) ◽  
pp. 75-80 ◽  
Author(s):  
Shahanaj Sharmin ◽  
Shahanara Chy ◽  
Diadrul Alam ◽  
Nasreen Banu ◽  
Fahmida Rashid ◽  
...  

Objective(s): The aim of this study was to evaluate the association of serum C-reactive protein (CRP) in preeclampsia (PE) and its effect on fetal birth weight.Materials and methods: This case control study was conducted in Chittagong Medical College Hospital, Bangladesh, from July 2013 to June 2014. Study population was pregnant women of third trimester with preeclampsia (case group) and normal blood pressure (control group). The maternal serum C-reactive protein (CRP) levels were measured by immune turbidometric assay between 32 weeks to term. The women were divided into three groups: mild PE, severe PE (according to ACOG criteria) and normal healthy group. The value of CRP and its correlation with birth weight was compared between groups.Results: One hundred and fifty (150) pregnant women were analyzed. Among them 50 were case and 100 control. There was no difference between age of the patients of both groups. The mean systolic blood pressure was 148.40 ± 12.35 mm Hg in case and 122.15 ± 6.44 mmHg in control group. The mean diastolic blood pressure was 100.00 ± 9.74 mmHg in case and 74.05 ± 5.97 mmHg for the control. The systolic and diastolic blood pressure was significantly higher in preeclamptic group (P < 0.000). C-reactive protein was 10.28 ± 7.25 mg/ mL in mild PE and 10.94 ± 6.32 mg/mL in severe PE and 3.45 ± 1.71 mg/mL in normotensive group, which was significantly higher in case than control group (P = 0.000). Preeclamptic women delivered at a significantly shorter gestational age than normal pregnant women. Mean gestational age during delivery for the case group and control group was 39.02 ± 1.6 and 39.58 ± 0.8 weeks respectively. Mean birth weight in PE (2.52 ± 0.42 kg) was significantly lower than normal pregnancies (2.88 ± 0.29 kg). The sensitivity and specificity of CRP were 68% and 98% respectively. Multiple regression analysis showed that there is a strong association between CRP levels and PE and birth weight.Conclusion: This small study showed that in case group CRP was raised in 68% cases which is much higher in comparison to healthy control group where CRP was high only in 2% cases. High CRP has association with low birth weight. Therefore, CRP may be used as cost effective investigation to identify the risk of preeclampsia and its effect on fetal birth weight.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 75-80


2021 ◽  
Vol 9 (4) ◽  
pp. 235-240
Author(s):  
Manoj Kumar ◽  
◽  
Chandrashekhar Tiwari ◽  
Nandita Prabhat ◽  
Pooja Dhaon ◽  
...  

Introduction: C-reactive protein (CRP) is a member of the class of acute phase reactants as itslevel rises dramatically during inflammatory processes occurring in the body. Measuring and chartingCRP values can prove useful in determining the disease progress. Aim: To estimate the CRP level inCerebrospinal fluid (CSF) of patients with meningitis; and to evaluate whether CRP levels could beused to differentiate the various types of meningitis in adults. Materials and Methods: This studywas a case-control study. 80 enrolled patients were subjected to a protocol that included detailedclinical history including duration of illness, symptoms and signs, history or any treatment history.Written informed consent was taken from the patients/guardian. Results: Meningitis was morecommon in the 18-30 years age group. Mean values of CSF CRP were- viral meningitis (2.70 mg/L)and pyogenic meningitis (91.13 mg/L) and control group (1.54 mg/L). CSF CRP can be used as adiagnostic tool to differentiate between pyogenic and viral meningitis as it is significantly raised inpyogenic meningitis in comparison to viral meningitis (p-value <0.0001). Conclusion: CRP in CSF isa valuable, rapid, bedside diagnostic test for differentiating between pyogenic and viral meningitis;with reasonably good sensitivity, specificity and positive predictive value. The absence of CRP in CSFrather than its presence is more important for the diagnosis of viral meningitis.


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.


2017 ◽  
Vol 44 (3) ◽  
pp. 297-303 ◽  
Author(s):  
Hubert de Boysson ◽  
Eric Liozon ◽  
Delphine Larivière ◽  
Maxime Samson ◽  
Jean-Jacques Parienti ◽  
...  

Objective.Our aim was to describe patients with giant cell arteritis (GCA)–related stroke and to compare them with a control group of GCA patients without stroke.Methods.We created a retrospective multicenter cohort of patients with (1) GCA diagnosed according to the American College of Rheumatology criteria between 1995 and 2015, and (2) stroke occurring at the time of GCA diagnosis or occurring within 4 weeks of starting GCA therapy. The control group consisted of GCA patients without stroke.Results.Forty patients [21 women (53%), median age 78 (60–91) yrs] with GCA-related stroke were included and were compared with 200 control patients. Stroke occurred at GCA diagnosis in 29 patients (73%), whereas it occurred after diagnosis in 11 patients. Vertebrobasilar territory was involved in 29 patients (73%). Seven patients died within a few hours or days following stroke. Compared with the control group, stroke patients had more ophthalmic ischemic symptoms [25 (63%) vs 50 (25%), p < 0.001]. Conversely, they demonstrated lower biological inflammatory variables [C-reactive protein: 61 (28–185) mg/l vs 99 (6–400) mg/l, p = 0.04] and less anemia [22/37 (59%) vs 137/167 (79%), p = 0.03] than patients without stroke. Multivariate logistic regression revealed that the best predictors for the occurrence of stroke were the presence of ophthalmic ischemic symptoms at diagnosis (OR 5, 95% CI 2.14–12.33, p = 0.0002) and the absence of anemia (OR 0.39, 95% CI 0.16–0.99, p = 0.04).Conclusion.Stroke, especially in the vertebrobasilar territory, is more likely to occur in patients with GCA who experience recent ophthalmic ischemic symptoms and who exhibit low inflammatory variables.


2012 ◽  
Vol 2 (1) ◽  
pp. 13-16
Author(s):  
Jozo Ćorić ◽  
Aleksandra Pašić ◽  
Mirsad Panjeta ◽  
Jasminka Mujić

Introduction: Low sensitivity and specificity in traditional laboratory tests became insufficient for accurate diagnostics and initiation of proper treatment of patients infected with bacterial meningitis. High sensitivity C reactive protein (hsCRP) may be an appropriate supplement for rapid diagnosis of bacterial meningitis. The subject of our investigation was the determination of C- reactive protein in cerebrospinal fluid (CSF) duringacute bacterial meningitis.Methods: HsCRP was analysed by a sensitive immunoturbidimetric assay using the Dimension RxL analyser (Siemens). Cerebrospinal fluid concentrations of C-reactive protein have been measured in 20 patients(age range,1 to 50 years) presenting with acute bacterial meningitis and also in a non-infected, non-inflamed control group (n=25).Results: The accuracy and precision of the method proved to be satisfactory. Repeatability of serial sampling for hsCRP described by coefficient of variation were CV=2.1-4.5%. This assay hsCRP in cerebrospinal fluid demonstrates adequate performance characteristics for routine clinical use. Elevated levels of CRP were found in 95% patients with bacterial meningitis. The mean CRP value in 25 uninfected control group was 0.25 mg/L (range 0.10-0.55). The mean CRP for patients with bacterial meningitis was 21.4 mg/L (range 0.40-100).Conclusions: A sensitive assay for CRP in CSF would be an useful adjunct to conventional investigation of acute infective meningitis.


2014 ◽  
Vol 61 (4) ◽  
Author(s):  
Şerafettin Demir ◽  
Gulhan Karakoyun ◽  
Mehmet Kanadasi

The aim of this study is to examine uric asid (UA) and high sensitive C-Reactive protein (Hs-CRP) levels in patients with coronary artery ectasia (CAE). Ninety-eight patients with isolated CAE (mean age 57.5±10.3), (group-I), 110 patients with CAD but without CAE (mean age 56.3±10.7), (group-II), and 105 patients with normal coronary angiographies (mean age 58.1±10.8), (group-III) were included in the study. Blood samples of all individual were taken after coronary angiography from an antecubital vein, the patients uric acid and Hs-CRP levels were assessed. The severity of ectasia was evaluated and categorized according to Markis. A significant difference was not seen in serum uric acid and Hs-CRP levels between CAE and CAD groups. However, relative to the control group, uric acid and Hs-CRP levels in CAE and CAD groups were higher to a significant degree (p=0.001, p


Author(s):  
Surinder Gupta ◽  
Preeti Garg ◽  
Nikita Gupta ◽  
Nakul Gupta

<p class="abstract"><strong>Background:</strong> Psoriasis, a chronic inflammatory disease, is associated with systemic comorbidities. The blood levels of various inflammatory markers are increased in psoriasis. One of them is high sensitivity C-reactive protein (hs-CRP). The serum level of hs-CRP is increased in many inflammatory diseases like psoriasis, cardio vascular diseases, infections, arthritis and others. The objectives of the study were to determine serum level of hs-CRP in psoriasis in relation to its PASI score, which is a subjective method to determine severity of the disease, whereas hs-CRP is an objective and more reliable method. And to have a better idea of systemic inflammatory process caused by psoriasis, serum level of hs-CRP was evaluated in psoriasis patients.</p><p class="abstract"><strong>Methods:</strong> A case control study was conducted including 38 patients of chronic plaque psoriasis from dermatology outpatient department of Maharaja Agrasen Medical College (MAMC), Agroha, India, and 38 healthy controls.<strong></strong></p><p class="abstract"><strong>Results:</strong> The serum level of hs-CRP was significantly raised in psoriasis patients (p&lt;0.001). The mean hs-CRP level in psoriasis patients was 6.824±8.562 mg/l whereas it was 1.072±0.929 mg/l in controls. Two observations were noticed, one, the increase in hs-CRP level correlated with PASI score and second, it was much higher in psoriatic patients as compared to controls.</p><p class="abstract"><strong>Conclusions:</strong> The much higher hs-CRP levels in psoriasis as compared to controls and its correlation with severity of psoriasis has led us to propose that this much high hs-CRP is a biomarker of systemic inflammatory process of psoriasis as well as inflamed cutaneous lesions.</p><p> </p>


2021 ◽  
pp. 1-6
Author(s):  
Pinar Dervisoglu ◽  
Taliha Oner

Abstract Background: Pulmonary vascular damage may be associated with oxidative stress in congenital heart diseases. We investigated whether small ventricular septal defects have an effect on the pulmonary bed. Methods: This prospective cohort study included 100 patients with small ventricular septal defects and 75 healthy controls. Ischemia-modified albumin, high-sensitivity C-reactive protein, and various cardiovascular parameters were assessed in both groups. Results: The mean ischemia-modified albumin level was significantly higher in patients with small ventricular septal defects (0.62 ± 0.17 absorbance units) than in the control group (0.51 ± 0.09 absorbance units; p < 0.001). The mean high-sensitivity C-reactive protein level was significantly higher in the ventricular septal defects group (3.72 ± 1.57) than in the control group (2.45 ± 0.89; p < 0.001). The ischemia-modified albumin levels in patients with left ventricular internal diameter end diastole and end sistole and main pulmonary artery z-scores ≥ 2 were significantly higher than patients whose z-scores were <2. The ischemia-modified albumin and high-sensitivity C-reactive protein levels were positively correlated in the small ventricular septal defects group (rho = 0.742, p < 0.001). Receiver operating characteristic analyses showed that at the optimal cut-off value of ischemia-modified albumin for the prediction of pulmonary involvement was 0.55 absorbance units with a sensitivity of 60%, specificity of 62% (area under the curve = 0.690, p < 0.001). Conclusions: We demonstrated the presence of oxidative stress and higher ischemia-modified albumin levels in small ventricular septal defects, suggesting that ischemia-modified albumin might be a useful biomarker for evaluating the effects of small ventricular septal defects on the pulmonary bed.


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