C-REACTIVE PROTEIN AS A MARKER FOR ACUTE CORONARY SYNDROMES

Background For several years, acute coronary syndromes have been perce ived as causing the most hospital admissions. and even hospital mortal ity. The syndrome of unstable angina frequently progresses to acute my ocardial infarction but its pathogenesis is poorly understood, and pro gnosis determination is still problematic. We tested the hypothesis th at measurement of the C-reactive protein in patients admitted for ches t pain could be a marker for acute coronary syndromes. Methods and Res ults We studied 110 patients admitted with suspected ischaemic heart d isease, but without elevated serum creatine-kinase levels at the time of hospital admission. Patients were subsequently divided into two gro ups based on their final diagnosis: group 1 comprised patients with un stable angina; group 2 patients with acute myocardial infarction. We m easured the C-reactive protein at the time of hospital admission. The concentration of C-reactive protein was elevated in 59% of the patient s with a final diagnosis of acute myocardial infarction, and in 5% of the patients with a final diagnosis of unstable angina, (P<0.001). Con clusion This study indicates that C-reactive protein levels measured a t the time of admission in patients with suspected ischaemic heart dis ease could be a marker for acute coronary syndromes, and helpful in id entifying patients at high risk for acute myocardial infarction. Measu rement of C-reactive protein may have practical clinical significance in the management of patients hospitalized for suspected acute coronar y syndromes.