Elevated levels of C-reactive protein before coronary artery bypass grafting prediction recurrence of ischemic events

Recent studies have shown an involvement of the inflammatory system in the pathogenesis of ischemic heart disease, and markers of inflammation were fo und to be correlated with prognosis.(1-4) In unstable angina, elevated seru m levels of C-reactive protein (CRP), an aspecific but sensitive marker of inflammation, were found to have a short-term prognostic value unrelated to myocardial cell damage, myocardial ischemia, or activation of the hemostat ic system.(3,5,6) The long-term prognostic value of elevated CRP levels was reported in patients with stable or unstable coronary artery disease,(4,7, 8) and in healthy subjects with high(9,10) and low levels(11) of coronary r isk factors. Several randomized and observational studies have identified t he variables relevant to patients' prognosis after coronary artery bypass g rafting (CABG),(12-15) but none of these studies have identified a serologi c marker of long-term outcome or have considered the role of the inflammato ry system in patients with CABG. We studied 86 patients with stable or unst able ischemic heart disease who underwent CABG to ascertain whether an acti vation of the inflammatory system before surgery, detected by elevated seru m levels of CRP, was associated with prognosis.