European Journal of Biomedical and Pharmaceutical Sciences

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.