Study of high sensitive-CRP and cardiac marker enzymes in acute coronary syndrome

Background: inflammation has been proposed as a contributor to different stages in the pathogenesis of coronary heart disease (chd). high sensitive c-reactive protein (hs-crp),an acute-phase plasma protein synthesized by the liver,is the most extensively studied systemic marker of inflammation. elevated hs- crp concentrations early in acute coronary syndrome (acs),prior to the tissue necrosis,may be a surrogate marker for cardiovascular co-morbidities. the cardiac marker enzymes creatine kinase myocardial bound (ck-mb),aspartate aminotransferase (ast) and lactate dehydrogenase (ldh) have been known to be increased in coronary artery diseases. objective: the aim of the study was to measure hs-crp levels and other cardiac marker enzymes in acs patients and to compare the levels of hs-crp with other cardiac marker enzymes between st elevation myocardial infarction (stemi) and non-st elevation myocardial infarction (nstemi) patients. material and methods: the study group consisted of 207 consecutive patients admitted to sri siddhartha medical college hospital within the first 6 hours from the onset of chest pain. patients were diagnosed as unstable angina (ua),(n=84); stemi (n=63) and nstemi (n=60). acs patients were compared with 211 healthy age and sex matched controls. hs-crp,ck-mb,ast and ldh levels were measured by standard methods in both groups at baseline and for cases at 36-48 hours i.e. peak levels. results: acs patients had significantly (p<0.05) higher levels of hs-crp,ckmb,ast and ldh in comparison to controls at baseline. hs-crp,ck-mb,ast and ldh levels were significantly higher in stemi patients compared to nstemi patients (p<0.05) at baseline. there was a significant difference regarding peak hs-crp levels between the two groups,as stemi patients had significantly higher peak hs-crp levels compared to nstemi patients (p<0.05). conclusion: stemi patients have significantly higher peak hs- crp levels compared to nstemi patients. these data suggest that inflammatory processes play an independent role in the pathogenesis of myocardial infarction. thus,hs-crp assessment may assist in risk stratification after myocardial infarction. © journal of krishna institute of medical sciences university.