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. 2010;37(1):42-8.

Variation in high-sensitivity C-reactive protein levels over 24 hours in patients with stable coronary artery disease

Mevlut Koc  1 , Osman Karaarslan, Gulcan Abali, Mustafa Kemal Batur
Affiliations

Variation in high-sensitivity C-reactive protein levels over 24 hours in patients with stable coronary artery disease

Mevlut Koc et al. Tex Heart Inst J. 2010.

Abstract

Limited, controversial data exist regarding changes in high-sensitivity C-reactive protein (hs-CRP) levels over short times and the importance of detecting these changes in patients who have coronary artery disease (CAD). We investigated the variation of hs-CRP levels and their association with the severity of CAD in patients with stable CAD.We measured morning, midday, evening, and midnight hs-CRP levels in 124 patients (94 with CAD, 30 with normal coronary arteries), who were evaluated via coronary angiography and Gensini scoring. Patients were divided into 3 groups (normal coronary arteries, mild CAD, or severe CAD) according to Gensini score.Temporal hs-CRP levels varied significantly--the highest mean concentrations were found in the morning, and the lowest concentrations at midday (P <0.001). All temporal hs-CRP measurements and the absolute increase in hs-CRP levels were significantly higher in patients with severe CAD (both P <0.001). The most significant predictors of CAD severity were age (P=0.005), midday hs-CRP level (P <0.001), and brain natriuretic peptide level (P=0.045). Receiver operating characteristic curve analysis showed that cutoff values of hs-CRP taken at different times predicted severe CAD with similar sensitivity and specificity. Different cutoff values for temporal hs-CRP levels correlated with the severity of CAD. Serum levels of hs-CRP varied over 24 hours, whether patients had CAD or normal coronary arteries.

Keywords: Analysis of variance; C-reactive protein/analysis; biological markers/ blood; coronary artery disease/blood; coronary stenosis; predictive value of tests; reference values; time factors.

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Figures

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Fig. 1 Temporal variation of mean high-sensitivity C-reactive protein (hs-CRP) levels according to coronary artery disease (CAD) severity group. CI = confidence interval
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Fig. 2 High-sensitivity C-reactive protein (hs-CRP) levels (mean values ± SD) taken at 6-hour intervals around the clock, according to coronary artery disease (CAD) severity group.
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Fig. 3 The relationship between midnight levels of high-sensitivity C-reactive protein (hs-CRP) and coronary artery disease (CAD) severity score.
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