C-reactive protein and coronary artery disease: Additional evidence of theimplication of an inflammatory process in acute coronary syndromes

Background inflammation might promote the development of atherosclerosis, a nd high levels of C-reactive protein (CRP) and fibrinogen are associated wi th an increased risk of acute coronary events. Objective we assessed the levels of CRP and other risk factors in patients with angiographically documented coronary artery disease compared with heal thy volunteers and patients undergoing coronary angiography who had normal coronary angiograms. Methods Ultrasensitive immunoassay was used to measure CRP levels in 142 pa tients with coronary disease (group 1), 37 patients with; normal coronary a ngiograms (group 2), and 37 control healthy subjects (group 3). Results CRP levels were higher in group 1 (7.1 +/- 11.2 mg/L) compared with group 2 (4.8 +/- 4.0 mg/L) and group 3 (2.3 +/- 3.6 mg/L). In group 1, CRP levels were higher for patients with previous myocardial infarction (8.7 /- 9.2 mg/L) or unstable angina (11.6 +/- 18.8 mg/L). Though CRP levels in patients with coronary artery disease and stable symptoms were higher compa red with healthy volunteers (5.15 +/- 7.2 mg/L vs 2.3 +/- 3.6 mg/L, P < .05 ), they were similar to those observed in the control population of patient s with normal coronary angiograms (4.8 +/- 4.0 mg/L). Furthermore, CRP leve ls were positively correlated,to plasma Fibrinogen but not to Chlamydia pne umoniae or Helicobacter pylori serology. Conclusion These results suggest that CRP has a strong association with acu te coronary events but do not support the hypothesis that CRP is a potent d eterminant of chronic stable coronary disease.