Abstract
VALUE OF HIGH SENSITIVE CRP IN HYPERGLYCEMIC PATIENTS WITH ACUTE CORONARY SYNDROME.

Yasser M. Kamal, Nayel Abd Elhamed Zaki, Omar Saad Mohammed and Magda Mohamed Ali*

ABSTRACT

Background: Hyperglycemia on admission in patients with acute coronary syndromes is common, and it is a powerful predicator of increased risk of in hospital complications in patients with and without diabetes mellitus, high sensitivity c- reactive protein (hs- CRP) is a cardiovascular risk marker in patients with acute coronary syndrome. Objectivs: 1. To determine the levels of high-sensitivity C-reactive protein (hs-CRP) in subjects of acute coronary syndrome with admission hyperglycemia whatever diabetic or not. 2. To determine the levels of high-sensitivity C-reactive protein (hs-CRP) in subjects of acute coronary syndrome without admission hyperglycemia. 3. To compare the results of the above two groups and assess the prognostic value of admission glucose and hs -CRP levels in hyperglycemic patients with acute coronary syndromes. Design and Setting: Prospective study, at Sohag university hospital in Egypt. Methods: We measured the blood glucose, hs -CRP, cardiac enzymes and HBAIClevels at admission in 100 consecutive patients with ACS. Glucose was categorized as ≤11.1mmol=<200 mg/ dl and ≥ 11.1 mmol=>200 mg/ dl. hs -CRP negative <1 and positive >3 mg, HBAIC ≤ 6.5% or ≥ 6.5). Results: In our study reveals a statistically significant relation between levels of admission glucose and left ventricular function (LVfailure, pulmonary edema and cardiogenic shock) or arrhythmias in hyperglycemic patients with ACS (P< 0.0001). Also there is a significant relation between level of hs- CRP and LVF and type of myocardial infarction in-hospital complications. Also there is insignificant relation between HBAIC levels and left ventricular function in ACS at admission. Conclusion: We conclude that elevated admission glucose appears a more important in predicting in-hospital and short term complications particularly left ventricular failure and cardiogenic shock in patients with acute coronary syndromes. Also the increased levels of hs- CRP are a predictor for severity and extent of myocardial damage and left ventricular function especially in STEMI. The synergistic effect of associated both stress hyperglycaemia and hs- CRP is a strong predictor for poor ACS outcome.

Keywords: High-sensitivity C-reactive protein level, Hyperglycemia, Inflammatory marker, Atherosclerosis, Acute coronary syndrome.


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