The level of C-Reactive Proteine at Admission does not Correlate with the Severity of Ischemic Activity or Left Ventricular Dysfunction in Unstable Angnia

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Abstract

Objective

To explore the hypothesis that in patients with unstable angina admitted to the coronary care unit, the levels of inflammatory activity correlate with the severity of ischemic activity and left ventricular function.

Methods

One hundred and ninety-four consecutive patients with unstable angina without prior myocardial infarction or total CK elevation post-admission were included. Measurement of C-reactive protein CRP) level and fibrinogen were performed at admission.Patients were also submitted to Holter monitoring and a 2-D-echocardiogram during the initial 24 hours.

Results Mean age of the patients was 66.0 ± 11.1 years, 62.4% were male and 41.2% had ST segment depression on admission ECG. Prevalence of silent ischemia and of acute left ventricular wall motion abnormalities were 25.8% and 43.8%, respectively. CRP levels at admission were associated neither to the severity of the initial ischemic burden nor to the number or severity of ischemic episodes during the 24-hour Holter recordings. There was also absence of correlation between CRP levels and the degree of left ventricular dysfunction. CPR levels at admission were positively correlated with fibrinogen. Conclusions The degree of baseline inflammatory activity does neither predict the severity of ischemic activity nor the alteration in left ventricular function during the initial stages of hospitalization in patients with unstable angina without evidence of recent or old MI.