C-reactive protein concentrations and angiographic characteristics of coronary lesions

Background: C-Reactive protein (CRP) is a strong predictor of clinical outc ome in coronally artery disease (CAD), and inflammation has been implicated in the process. We aimed to evaluate whether CRP concentrations measured w ith a new, automated particle-enhanced immunoturbidimetric method for high- sensitivity Clip may be related to specific high-risk angiographic features of coronary lesions. Methods: In a cross-sectional study, we examined 103 consecutive patients u ndergoing cardiac catheterization for suspected CAD. We assessed the associ ation of preprocedural CRP concentrations with clinical presentation (unsta ble angina) and angiographic features of coronary lesions. Results: Twenty patients had unstable angina. Independent predictors of uns table angina included increased CRP [odds ratio (OR), 2.93 per 10-fold incr ease in CRP; 95% confidence interval ICI), 1.28-6.69; P = 0.01] and the pre sence of macroscopic thrombus (OR, 7.08; 95% CI, 1.33-37.8; P = 0.02). Thir ty-two culprit lesions had macroscopic thrombus or eccentric/irregular disc rete morphology without total occlusion. Increased CRP was the strongest pr edictor of such features (OR, 2.04 per 10-fold increase in CRP; 95% CI, 1.0 3-4.04 P = 0.04), and the effect was independent of the presence of unstabl e angina. Conclusions: Among patients with suspected CAD undergoing coronary angiogra phy, increased CRP is strongly associated with unstable angina and with spe cific high-risk features of the culprit coronary lesions. (C) 2001 American Association for Clinical Chemistry.