CRP Levels are Higher in Patients with ST Elevation Than Non-ST Elevation Acute Coronary Syndrome

Background: There is intense interest in the use of high-sensitivity C-reactive protein (hsCRP) for risk assessment. Elevated hsCRP concentrations early in acute coronary syndrome (ACS), prior to the tissue necrosis, may be a surrogate marker for cardiovascular co-morbidities. Objective: Therefore we aimed to study different follow up measurements of hsCRP levels in acute coronary syndrome patients and to compare the difference between non-ST elevation myocardial infarction (NSTEMI) and ST myocardial infarction (STEMI) patients. Methods: This is an observational study. Of the 89 patients recruited 60 patients had acute myocardial infarction (AMI). Three serial hsCRP levels at baseline on admission to hospital before 12 hours of symptom onset, peak levels at 36-48 hours and follow up levels after 4-6 weeks were analyzed and compared between non-ST elevation AMI and ST elevation AMI. Results: STEMI patients had significantly higher BMI compared to NSTEMI patients. Creatine kinase myocardial bound (CKMB) and Aspartate aminotransferase (AST) levels were significantly higher in STEMI patients compared to NSTEMI patients (p<0.05). CRP levels at baseline and at follow up did not significantly differ between the two groups (p=0.2152, p=0.4686 respectively). There was a significant difference regarding peak CRP levels between the two groups, as STEMI patients had significantly higher peak CRP levels compared to NSTEMI patients (p=0.0464). Conclusion: STEMI patients have significantly higher peak CRP levels compared to NSTEMI patients. These data suggest that inflammatory processes play an independent role in the pathogenesis of myocardial infarction. Thus, CRP assessment may assist in risk stratification after myocardial infarction. (Arq Bras Cardiol 2011; 96(1): 13-17)