CORRELATION BETWEEN HIGH SENSITIVE C- REACTIVE PROTEIN LEVEL AND INFARCTION SIZE IN NON-ST ELEVATION MYOCARDIAL INFARCTION

Abstract

SUMMARY N on ST elevation myocardial infarction is one of the most frequent manifestations of acute coronary syndrome. Echocardiography is the most important modality in the acute setting in patients follow up because it is widely available. It is a reasonable tool in diagnosis, prognosis, early risk stratification, and follow up for patients with non ST elevation myocardial infarction. The high-sensitive C-reactive protein (HS-CRP) assay is being increasingly used as a marker for cardiac risk assessment and as a prognostic tool in heart disease. There is a relationship between serum level of HS-CRP and extension of myocardial involvement in myocardial infarction. It may be also helpful in assessing risk of other processes involving inflammation. This study was done to find out the correlation between HS-CRP serum level and infarction size in patients with non ST elevation myocardial infarction. One hundred patients with non ST elevation myocardial infarction were included in this study that had history of typical chest pain for more than 20 minutes associated with dyspnea, nausea, vomiting, sweating and near syncope without persistent ST-segment elevation and elevated myocardial markers (Total CK, CKMB and cardiac Troponin I). Patients with ST elevation myocardial infarction, new LBBB, angina of secondary etiology, active infection or chronic inflammatory disease, recent surgery, significant hepatic or renal dysfunction and body temperature > 37.8 Ć on admission were excluded from our study. They were subjected to complete medical history, clinical examination, ECG, laboratory investigations and detailed transthoracic echocardiography. The results of our study showed significant positive correlation between serum levels of HS-CRP and the age (p-value = 0.014). Also showed significant positive correlation between serum levels of HS-CRP and the cardiac markers (CKMB and Troponin I) (p-value = 0.025 and 0.010 respectively). There was significant inverse correlation between serum levels of HS-CRP and the ejection fraction (p-value = 0.050) and significant positive correlation between serum levels of HS-CRP and wall motion score index (WMSI) (p-value = 0.001). However, the results of our study revealed no significant correlation between serum levels of HS-CRP and LV diastolic function measured by pulsed wave Doppler and tissue Doppler.