The Role of High-sensitive C-Reactive Protein in predicting Severity of Coronary Artery Disease in Patients with Acute Coronary Syndromes

Abstract

Objectives: We investigated the correlation between baseline C-reactive protein (Hs-CRP) levels and severity of coronary artery disease (CAD), measured in terms of Syntax Score (SScore), among patients presenting with acute coronary syndromes (ACS). Methodology: This cross-sectional study was conducted at the Armed Forces Institute of Cardiology (AFIC), Rawalpindi, from April 2022 to October 2022. Baseline Hs-CRP levels were obtained for all the patients. Patients were divided into three groups as per the SScore as low (≤ 22), intermediate (≥ 23), and high (≥ 33) burden of CAD. Results: Out of the 200 patients studied, 82.5% (165) were males, and mean age was 60.16±10.66 years. Diabetics were 50% (100) of the sample, 48.5% (97) were hypertensive, and smokers were 17.5% (35). Median Hs-CRP was 4.0 mg/L [2.0-12.5 mg/L], and median left ventricular ejection fraction (LVEF) was 45% [40-55%]. Median SScore was 23.5 [14.5-30.0], with 44.5% (89) categorized as low, 36.5% (73) as intermediate, and 19% (38) as high burden of CAD. The correlation between Hs-CRP and SScore was 0.236 (p=0.001) and -0.229 (p=0.001) with LVEF. A significant increase in Hs-CRP was observed in relation to the burden of CAD (p<0.001) with median of 2.0 mg/L [1.0-4.2 mg/L], 6.0 mg/L [3.1-15.7 mg/L], and 12.5 mg/L [5.8-20.7 mg/L] for low, intermediate, high burden of CAD, respectively. Conclusion: Admission Hs-CRP was found to be positively correlated with the burden of CAD and negatively correlated with LVEF in patients with ACS.