Coronary Artery DiseaseComparison of the prognostic value of C-Reactive protein and troponin I in patients with unstable angina pectoris☆
Section snippets
Patient group
Three hundred nine consecutive patients admitted to the coronary care unit of Hôpital Bichat with a clinical diagnosis of unstable angina, defined as angina at rest, recent onset, or crescendo angina (<4 weeks) with chest pain within the previous 48 hours, were considered eligible for the study. Patients with myocardial infarction at admission (total creatinine kinase [CK] >2 times above normal and increased CK-MB isoenzyme mass during the first 48 hours) (n = 43) or with myocardial infarction
Unselected unstable angina population
In the study population (n = 195), elevated cTnI, but not elevated CRP, within 24 hours of admission was predictive for major adverse cardiac events, myocardial infarction or death, and myocardial infarction (Table I). In patients with normal cTnI values within the first 24 hours, the frequency of major adverse cardiac events was similar in patients with (n = 73) or without (n = 62) elevated CRP (≥6 mg/L) within 24 hours (7% vs 6%, NS).
Clinical characteristics and in-hospital outcome
Patients’ mean age was 61 ± 1 years; 75% were men. A
Discussion
Treatment of unstable angina should ideally be tailored to the short-term risk of major adverse cardiac events. Recurrent ischemia in patients receiving medical therapy is associated with a poor prognosis.1, 2 In our study, we demonstrated that recurrent ischemia was a strong predictor for in-hospital adverse events. However, earlier parameters are needed for decision making. Markers of myocardial injury, such as troponins I and T, may be elevated in the absence of other signs of myocardial
Acknowledgements
The authors are grateful to DADE laboratories (Massy, France) for supplying the cardiac troponin I assay kits and are indebted to the personnel of the Coronary Care Unit and the nurses of the catheterization laboratory.
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2019, International Journal of CardiologyCitation Excerpt :Previous reports have measured hsCRP at least 30 days after ACS to assess residual inflammation [21,36] or have examined pre-discharge hsCRP concentrations [37]. In ACS patients, hsCRP concentrations increase beginning 6 h after the onset of ischemia and peaking at approximately 48 h [9,38,39]. In our study, the median hsCRP level was greater in NSTEMI/UA patients compared with STEMI patients (3.4 vs 2.4 mg/l), which is in contrast to previous reports [38,39].
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This study was supported in part by a grant from the Fédération Française de Cardiologie, Paris, France.