Sheikh A S, Yahya S, Sheikh N S, Sheikh A A
Department of Cardiology, Southend University Hospital NHS Foundation Trust, Essex, UK.
Heart Views. 2012 Jan;13(1):7-12. doi: 10.4103/1995-705X.96660.
The acute-phase reactant C-reactive protein (CRP) has been shown to reflect systemic and vascular inflammation and to predict future cardiovascular events. The objective of this study was to evaluate the prognostic value of CRP in predicting cardiovascular outcome in patients presenting with acute coronary syndromes.
This prospective, single-centered study was carried out by the Department of Pathology in collaboration with the Department of Cardiology, Bolan Medical College Complex Quetta, Balochistan, Pakistan from January 2009 to December 2009. We studied 963 consecutive patients presenting with chest pain to Accident and Emergency Department. Patients were divided into four groups. Group-1 comprised patients with unstable angina; group-2 included patients with acute ST elevation myocardial infarction (STEMI); group-3 comprised patients with Non-ST elevation myocardial infarction (Non-STEMI) and group-4 was the control group. All four groups were followed-up for 90 days for occurrence of cardiovascular events.
The CRP was elevated (>3 mg/L) among 27.6% patients in Group-1; 70.9% in group- 2; 77.9% in group-3 and 5.3% in the control group. Among cases with elevated CRP, 92.1% had a cardiac event compared to 34.3% among patients with CRP £3 mg/L (P < 0.0001). The mortality was significantly higher (P < 0.0001) in group-2 (8.9%) and group-3 (11.9%) as compared to group-1 (2.1%). There was no cardiac event or mortality in Group-4.
Elevated CRP is a predictor of adverse outcome in patients with acute coronary syndromes and helps in identifying patients who may be at risk of cardiovascular complications.
急性期反应物C反应蛋白（CRP）已被证明可反映全身和血管炎症，并预测未来心血管事件。本研究的目的是评估CRP在预测急性冠状动脉综合征患者心血管结局方面的预后价值。
本前瞻性、单中心研究由巴基斯坦俾路支省奎达市博拉恩医学院综合医院病理科与心脏病科合作开展，时间为2009年1月至2009年12月。我们研究了963例连续因胸痛就诊于急诊科的患者。患者分为四组。第一组为不稳定型心绞痛患者；第二组包括急性ST段抬高型心肌梗死（STEMI）患者；第三组为非ST段抬高型心肌梗死（非STEMI）患者，第四组为对照组。对所有四组患者进行90天的随访，观察心血管事件的发生情况。
第一组27.6%的患者CRP升高（>3mg/L）；第二组为70.9%；第三组为77.9%；对照组为5.3%。在CRP升高的病例中，92.1%发生了心脏事件，而CRP≤3mg/L的患者中这一比例为34.3%（P<0.0001）。与第一组（2.1%）相比，第二组（8.9%）和第三组（11.9%）的死亡率显著更高（P<0.0001）。第四组未发生心脏事件或死亡。
CRP升高是急性冠状动脉综合征患者不良结局的预测指标，有助于识别可能有心血管并发症风险的患者。
