C-REACTIVE PROTEIN ELEVATION AND EARLY OUTCOME IN PATIENTS WITH UNSTABLE ANGINA-PECTORIS

C-reactive protein, a reactant of the acute phase of inflammation, has been shown to be increased in patients with unstable angina, Moreover , it has recently been found that increased C-reactive protein is asso ciated with a poor outcome during hospitalization in selected patients with severe unstable angina, The aim of this study was to investigate the prognostic value of C-reactive protein elevation in a large popul ation with unstable angina, We measured serum levels of this marker in 140 patients hospitalized with unstable angina (class IIIB of the Bra unwald classification, mean time from last anginal episode 5 +/- 5 hou rs), Thirty-nine of them (28%) had increased serum levels on hospital admission and 33 (24%) experienced an adverse outcome (myocardial infa rction or refractory angina) during hospitalization, Kaplan-Meier anal ysis showed that the probability of developing cardiac events during h ospitalization was not different between patients with and without abn ormal C-reactive protein levels, Furthermore, the incidence of ischemi a at Holter monitoring during the first 72 hours after hospitalization was not different between patients with and without abnormal C-reacti ve protein, In a representative population of patients with unstable a ngina, a sizable proportion had increased serum C-reactive protein lev els; however, abnormal concentrations of C-reactive protein do not pre dict an adverse outcome in the early phase after the acute episode. (C ) 1997 by Excerpta Medica, Inc.