C-REACTIVE PROTEIN, LEUKOCYTE COUNT AND MYELOPEROXIDASE AS PREDICTORS OF ADVERSE CARDIAC EVENTS IN ACUTE CORONARY SYNDROME PATIENTS

Abstract

Objective: The aim of the present study was to evaluate the role of C-reactive protein (CRP), leukocyte count and myeloperoxidase (MPO) in predicting adverse outcomes in acute coronary syndrome patients. Methodology: Ninety consecutive patients with acute coronary syndrome (ACS) were enrolled from Coronary Care Unit of Shaikh Zayed Hospital, Lahore from January 2012 to April 2013. Baseline leukocyte count was determined by Abacus cell counter while CRP and MPO levels were determined by using commercially available enzyme immunoassays. Mortality and adverse cardiac events were recorded for a follow up period of 6 months. Results: Out of ninety patients 65 (72.2%) were males. Mean age of patients was 56.25±13.01 years (male patients 55.43±14.02 while female patients 58.4±9.88). Number of adverse events was highest (18.6%) in CRP > median category, followed by leukocyte count > median (17.9%) and MPO > median category (17.1%), respectively. Adverse event rate was found to be significantly higher (p = 0.043) in CRP > median category as compared to CRP < median category. Adverse event rate was also higher (p = 0.08) (clinically significant) in > median category of leukocyte count but in case of MPO level it did not reach level of statistical or clinical significance (p = 0.12). Conclusion: CRP is a predictor of adverse outcome in acute coronary syndrome patients and may serve as a marker in prognosis of ACS. Further studies with large sample size are required for confirmation of predictive role of leukocyte count.