Estudos prospectivos mostraram que os níveis plasmáticos de proteína C reativa de alta sensibilidade (PCR-as) são fortes preditores de eventos cardíacos. No entanto, a associação entre os níveis de PCR-as e a extensão da estenose coronária em pacientes com doença arterial coronária (DAC) permanece controversa.
Em um artigo publicado recentemente na revista Atherosclerosis, os autores investigaram a associação entre os níveis de PCR-as e a extensão da estenose coronária em 273 pacientes submetidos à angiografia coronária eletiva. Os níveis plasmáticos de PCR-as foram maiores nos pacientes com DAC do que naqueles sem DAC (0.70mg/l versus 0.56mg/l, P < 0.02), porém os níveis de PCR-as não relacionaram-se a > 50% de vasos estenóticos e não foram um fator significante para DAC.
No entanto, após a exclusão de 76 pacientes em uso de estatinas, um aumento gradual nos níveis de PCR-as foi encontrado dependendo de um valor > 50% dos vasos estenóticos: : 0.50 na DAC(−), 0.68 no vaso-1, 0.77 no vaso-2 e 0.88mg/l no vaso-3 (P < 0.01). Os níveis de PCR-as também associaram-se a > 50% e > 25% dos segmentos estenóticos (r = 0.30 e 0.32, P < 0.001). A análise multivariada revelou níveis de PCR-as como um fator significante para DAC.
Portanto, após a exclusão dos pacientes em uso de estatinas, os níveis plasmáticos de PCR-as estiveram associados à presença e extensão da estenose coronária em pacientes com DAC estável.
Associations of plasma C-reactive protein levels with the presence and extent of coronary stenosis in patients with stable coronary artery disease - Atherosclerosis – 2005; Volume 178, Issue 1:173-177
Associations of plasma C-reactive protein levels with the presence and extent of coronary stenosis in patients with stable coronary artery disease
Hiroaki Taniguchia, Yukihiko Momiyamaa,* , Reiko Ohmoria, Atsushi Yonemurab, Takeshi Yamashitac, Seiichi Tamaib, Haruo Nakamurac, Fumitaka Ohsuzua
Received 30 December 2003; received in revised form 15 July 2004; accepted 13 August 2004
Abstract
Prospective studies showed plasma high sensitivity C-reactive protein (hsCRP) levels to be a powerful predictor of cardiac events. However, the association between hsCRP levels and the extent of coronary stenosis in patients with coronary artery disease (CAD) remains controversial. We investigated the association between hsCRP levels and the extent of coronary stenosis in 273 patients undergoing elective coronary angiography. Plasma hsCRP levels were higher in patients with CAD than in those without CAD (0.70mg/l versus 0.56mg/l, P < 0.02), but hsCRP levels did not correlate with the number of >50% stenotic vessels and were not a significant factor for CAD. However, after the exclusion of 76 patients taking statins, a step-wise increase in hsCRP levels was found depending on the number of >50% stenotic vessels: 0.50 in CAD(−), 0.68 in 1-vessel, 0.77 in 2-vessel, and 0.88mg/l in 3-vessel disease (P < 0.01). The hsCRP levels also correlated with the numbers of >50% and >25% stenotic segments (r = 0.30 and 0.32, P < 0.001). Multivariate analysis revealed the hsCRP levels to be a significant factor for CAD. Thus, after the exclusion of patients with statins, plasma hsCRP levels were found to be associated with the presence and extent of coronary stenosis in patients with stable CAD.
Keywords: Coronary artery disease; C-reactive protein; Statin; Inflammation
Affiliations
a First Department of Internal Medicine, National Defense Medical College, Saitama, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
b Department of Laboratory Medicine, National Defense Medical College, Saitama, Japan
c Mitsukoshi Health and Welfare Foundation, Tokyo, Japan
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