Prognostic value of C-reactive protein in patients with stress induced myocardial ischemia

Federico Lombardi, Fabrizio Tundo, Paolo Terranova, Pier Maria Battezzati, Marina Ramella, Alberto Bestetti, Luca Tagliabue

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Inflammation plays a critical role in the pathogenesis of atherosclerosis. Possible association between C-reactive protein (CRP), stress-induced myocardial ischemia and clinical outcome was investigated. Design, patients and results: We correlated scintigraphic scan and CRP values of 101 consecutive out-patients who performed an exercise stress test for evaluation of chest pain (n=49) or scheduled control after myocardial infarction (n=52). CRP levels were determined before and after exercise. Twenty-three patients had reversible defects and presented CRP levels [mean (S.D.) 5.6 (3.3) mg/l] greater than subjects with fixed [mean (S.D.) 4.6 (4.5) mg/l] or no [mean (S.D.) 2.8 (2.9) mg/l] defects. Odds ratio for the association between high (3rd, tertile, >4.7 mg/l) CRP levels and reversible defects was 5.6 (95% CI 1.6 to 20; p=0.009). During a follow-up of 2.3 (0.7) years, 18 patients reached a clinical end-point consisting in one Q-wave myocardial infarction, eight non-Q-wave myocardial infarction or unstable angina and nine percutaneous coronary interventions. When the impact of different risk factors on the development of clinical endpoint was evaluated, the hazard ratio associated with high CRP levels was 11.0 (95% CI 3.0 to 41; p

Original languageEnglish
Pages (from-to)313-317
Number of pages5
JournalInternational Journal of Cardiology
Volume98
Issue number2
DOIs
Publication statusPublished - Feb 15 2005

Keywords

  • Exercise-induced ischemia
  • Inflammation and myocardial ischemia
  • Inflammation and prognosis
  • Scintigraphic scan

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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