Kocaeli University Medical Faculty, Department of Cardiology, Kocaeli, Turkey.
Atherosclerosis. 2009 Dec;207(2):591-6. doi: 10.1016/j.atherosclerosis.2009.05.035. Epub 2009 Jun 11.
Underlying predisposition for a heightened inflammatory response is postulated as one of the mechanisms for elevated high-sensitivity C reactive protein (hs-CRP) levels in patients with acute coronary syndrome (ACS). It is unclear whether metabolic syndrome (MetS) may cause a predisposition for heightened hs-CRP response in patients with ACS. The aim of this study is to investigate the interaction between hs-CRP levels and presence of MetS in patients with and without ACS.
Two hundred and seventy-three consecutive patients presenting with a first ACS event and 261 MetS patients without any ACS event were included to the study. The study participants were divided into three groups as MetS (+) ACS (-) [n=261], MetS (-) ACS (+) [n=110], and MetS (+) ACS (+) [n=163]. Median levels of hs-CRP were compared between and within the three groups.
Hs-CRP levels were lowest in MetS (+) ACS (-) subjects and highest in MetS (+) ACS (+) patients. Factors associated with hs-CRP levels were troponin elevation, presence of ACS, body mass index (BMI), and presence of MetS (R(2)=0.26, p<0.01). Predictors of elevated hs-CRP levels (>0.3mg/dl) were the presence of ACS (OR=3.6, 95% CI=1.9-6.5, p<0.01), presence of MetS (OR=2.1, 95% CI=1.0-4.0, p=0.02), troponin elevation (OR=5.7, 95% CI=2.8-11.5, p<0.01) and BMI (OR=1.1, 95% CI=1.0-1.1, p<0.01).
The presence of MetS had an impact on the increase in hs-CRP levels observed with an ACS event in the study population. These findings suggested that a heightened baseline inflammatory status of MetS may predispose ACS patients to an augmented hs-CRP response.
人们认为，急性冠脉综合征（ACS）患者体内存在的炎症反应增强倾向是导致高敏 C 反应蛋白（hs-CRP）水平升高的机制之一。目前尚不清楚代谢综合征（MetS）是否会导致 ACS 患者的 hs-CRP 反应增强。本研究旨在探讨 hs-CRP 水平与 ACS 患者中 MetS 存在之间的相互作用。
纳入了 273 例首次发生 ACS 的连续患者和 261 例无 ACS 事件的 MetS 患者。将研究参与者分为三组：MetS（+）ACS（-）[n=261]、MetS（-）ACS（+）[n=110]和 MetS（+）ACS（+）[n=163]。比较三组之间和组内 hs-CRP 的中位数水平。
hs-CRP 水平在 MetS（+）ACS（-）患者中最低，在 MetS（+）ACS（+）患者中最高。与 hs-CRP 水平相关的因素包括肌钙蛋白升高、ACS 存在、体重指数（BMI）和 MetS 存在（R2=0.26，p<0.01）。hs-CRP 水平升高（>0.3mg/dl）的预测因子为 ACS 的存在（OR=3.6，95%CI=1.9-6.5，p<0.01）、MetS 的存在（OR=2.1，95%CI=1.0-4.0，p=0.02）、肌钙蛋白升高（OR=5.7，95%CI=2.8-11.5，p<0.01）和 BMI（OR=1.1，95%CI=1.0-1.1，p<0.01）。
在研究人群中，MetS 的存在对 ACS 事件时 hs-CRP 水平升高有影响。这些发现表明，MetS 的基础炎症状态增强可能使 ACS 患者更容易产生 hs-CRP 反应增强。
