High Sensitivity C-Reactive Protein and Carotid Intima Media Thickness as Dual Predictors of Short Term Outcome in Patients with Acute Coronary Syndrome
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- Category: Vol. 82, June 2014
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High Sensitivity C-Reactive Protein and Carotid Intima Media Thickness as Dual Predictors of Short Term Outcome in Patients with Acute Coronary Syndrome, MAHMOUD A. SOLIMAN, GHADA M. SOLTAN, HESHAM H. EBRAHIM, ABDALLAH M. KAMAL and SHERIFF M. RASHED
Abstract
Introduction: Prediction of cardiovascular risk is of paramount importance particularly in patients with acute coronary syndrome. Traditional risk factors & existing models are still insufficient to close the detection gap.
Aim of the Work: To assess the relation between both high sensitively c-reactive protein, carotid intimae media thickness and short term outcome in patients with acute coronary syndrome.
Subjects and Methods: The present study enrolled 50 patients with acute coronary syndrome: 23 patients with STEMI representing group I, 27 patients with unstable angina representing group II.
All patients were subjected to: History taking, physical examination, twelve leads ECG daily & as required, as well as Echocardiography-carotid Dopplex examination.
Laboratory investigations including: Fasting blood sugar, lipid profile cardiac enzymes (CPK, troponin, LDH) serum creatinine & hsCRP.
Medical Protocol: All patients received the standard treatment of unstable angina or STEMI according to their presentations & followed-up during hospital stay & three months for recurrent pain, recurrent infarction, PCI, CABG & death.
Results: There was no significant difference between myocardial infarction group and unstable angina group as regards age, (55.87±7.42 vs 56.29±8.49), male sex (95.7 vs 85.2) diabetes (13% vs 29.6%), hypertension (39.8% vs 40.7%), smoking (52.2% vs 33.3%) & obesity (43.5 vs 37%).
Only, dyslipidaemia was significantly higher in MI group than UA group (60.9% vs 22.2% p-value <0.001).
There was no significant difference between both groups as regard cholesterol, TG, HDL, LDL, hsCRP & CIMT. Also, there was no significant difference as regards LVESD, LV EDD & EF.
Correlation between CIMT & adverse events (including anginal pain, reinfarction, HF, PCI, CABG & death) were non significant in both MI & UA groups p-value 0.05).
On the other hand significant positive correlation was found between hs CRP and CABG & death in both groups.
Conclusion: Carotid Intima media thickness has poor correlation with short term clinical outcome in patients with acute coronary syndrome while Hs CRP has significant positive correlation particularly with CABG & death.