Fluctuations of High-sensitivity C-reactive Protein in acute Coronary Syndrome

Abstract

Background: Atherosclerosis is associated with low-grade vascular inflammation that can be measured with high sensitivity-C reactive protein (hs-CRP). Acute coronary syndrome (ACS) events are thought to occur due to plaque rupture which is induced by the inflammatory process. Therefore with the onset of ACS there is a rise of hs-CRP from the baseline levels. This study was carried out to observe the fluctuations in serum hs-CRP concentrations after ACS and to determine the optimal time for blood sampling for hs-CRP that represents the baseline value.

Methods: Serial estimates of serum hs-CRP were done in patients admitted with ACS by turbidimetry. Samples were taken, on admission, day three, five, 24 and 84 from the onset of symptoms.

Results: Eight male patients (mean age 53, SD 5 yrs) with ACS (five with ST- elevation myocardial infarction and three with unstable angina) were included. Serum mean (SD) hs-CRP level on admission was 3.06 (1.3) mg/L. Then levels rose to 6.17 (2.6) mg/L on day three; was significantly different from on admission value (p = 0.013). Then it declined to 4.37 (1.8) mg/L on day five and on 24th day to 3.21 (1.2) mg/L. The value on 84th day was 3.12 (1.4) mg/L. No significant difference was observed between the mean hs-CRP level on admission and on day five (P = 0.20), on day 24 (p = 0.81) and on day 84 (p = 0.93), respectively.

Conclusion: Serum hs-CRP fluctuates after ACS, peaked on day three, returns to the basal level by day five following the acute event. Therefore basal level is more reliably reflected by the on admission sample.