Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Patients with ischemic discomfort may present with or without STsegment elevation on the ECG. The majority of patients with ST-segment elevation ultimately develop a Q-wave AMI (QMI).
Patients who present without ST-segment elevation are either experiencing unstable angina (UA) or a non-STsegment elevation MI (NSTEMI). Most patients with NSTEMI do not evolve a Q-wave and are subsequently referred to as having sustained a non-Q-wave MI (NQMI). The spectrum of clinical conditions ranging from acute myocardial infarction through minimal myocardial injury to unstable angina comprises the acute coronary syndrome (ACS). Measurement of C-reactive protein (CRP) may have practical clinical significance in the management of patients hospitalized for suspected ACS.
OBJECTIVE:
To study different follow up measurements of high sensitive C-Reactive Protein (hsCRP) levels in ACS patients and to compare the difference between (NSTEMI) and (STEMI) patients.
METHODS:
122 patients with ACS participate in this study through years 2006-2008. Three serial hsCRP levels at baseline on admission to hospital before 12 hours of symptom onset, peak levels at 3 days and follow up levels after 5 days were analyzed and compared between non-ST elevation AMI, ST elevation AMI and UA elevation.
RESULTS:
The results were compared with those of healthy groups as controls.
The results showed a significant elevation in serum CRP levels on 1st, 3rd and 5th reaching optimum value on day 3 post infarction in QMI and NQMI patients, While there was a non significant increase in serum CRP level in patients with UA on day 1, and day 3 post attack.
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.