CRP and cardiovascular risk in unstable angina patients

Liuzzo et al. [40] studied the prognostic role of CRP levels in 32 patients with stable angina, 31 unstable angina patients and 29 myocardial infarction patients. A CRP threshold value of 3 mg/l was used, based on the 90th percentile of the normal distribution observed in the study. Unstable angina patients had higher CRP concentrations than stable angina patients. Moreover, unstable angina patients with high CRP concentrations had more ischaemic episodes (4.8 ± 2.5 versus 1.8 ± 2.4; p = 0.004), and were more likely to die (nonsignificant trend) during coronary care unit admission than those with the lowest concentrations of CRP. These findings were later confirmed by a larger study of 965 patients with unstable angina or nonQ-wave myocardial infarction (FRISC [Fast Revascularization during Instability in Coronary artery disease]) [47]. However, only a trend of increased CRP was found in the group who died and/or had a new myocardial infarction compared with patients with no events during follow up (7.5 [1-17] versus 5 [0-14], respectively; p= 0.067). In this study, logistic multiple regression analysis showed that CRP was not an independent risk factor for death or myocardial infarction. A recent study by Ferreiros et al. [48] showed that CRP measured at hospital admission was not predictive of events at discharge.

However, they found that CRP measured at hospital discharge was highly predictive of coronary risk at 90 days [48].

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