C-Reactive protein and coronary artery disease: Additional evidence of the implication of an inflammatory process in acute coronary syndromes,

Background Inflammation might promote the development of atherosclerosis, and high levels of C-reactive protein (CRP) and fibrinogen are associated with an increased risk of acute coronary events. Objective We assessed the levels of CRP and other risk factors in patients with angiographically documented coronary artery disease compared with healthy volunteers and patients undergoing coronary angiography who had normal coronary angiograms. Methods Ultrasensitive immunoassay was used to measure CRP levels in 142 patients with coronary disease (group 1), 37 patients with normal coronary angiograms (group 2), and 37 control healthy subjects (group 3). Results CRP levels were higher in group 1 (7.1 ± 11.2 mg/L) compared with group 2 (4.8 ± 4.0 mg/L) and group 3 (2.3 ± 3.6 mg/L). In group 1, CRP levels were higher for patients with previous myocardial infarction (8.7 ± 9.2 mg/L) or unstable angina (11.6 ± 18.8 mg/L). Though CRP levels in patients with coronary artery disease and stable symptoms were higher compared with healthy volunteers (5.15 ± 7.2 mg/L vs 2.3 ± 3.6 mg/L, P < .05), they were similar to those observed in the control population of patients with normal coronary angiograms (4.8 ± 4.0 mg/L). Furthermore, CRP levels were positively correlated to plasma fibrinogen but not to Chlamydia pneumoniae or Helicobacter pylori serology. Conclusion These results suggest that CRP has a strong association with acute coronary events but do not support the hypothesis that CRP is a potent determinant of chronic stable coronary disease. (Am Heart J 1999:137:346-51.)