Applicational Value Of High-sensitivity C-reactive Protein In Patients With Coronary Heart Disease

Objective To compare the variation and interaction of high- sensitivity C-reactive protein(hs-CRP) and other risk factors such as smoking, hypertension, diabetes mellitus and blood lipid, to observe the variation of serum hs-CRP level in patients with the different types of coronary heart disease(CHD), to primary study the effect of hs-CRP in atherosclerosis(AS), to investigate the applicational value of hs-CRP in the clinical diagnose of coronary heart disease, and hope more and more people to concern the clinical study development of hs-CRP.Methods 68 patients came from the XinHua hospital attached to Dalian University and were studied as the coronary heart disease group.The control group include 37 matched healthy volunteers. On the basis of different degrees, the coronary heart disease group were divided into three subgroups, they were stable angina pectoris(n=19), accelerated angina pevtoris(n=36) and acute myocardial infarction(n=13). The 4ml fasting blood specimens of all individuals were collected in morning, centrifugalize serum within 30 minutes, store serum at -28℃to detect together. In order to understand the substance concentration, the following test were evaluated with HITACHI 7180 type automatic biochemitry analyzer, the serum hs-CRP level was measured with the double wavelength immunity transmission turbidimetric method; the oxidase method was used to detect fasting blood glucose(FBG), triglyceride(TG) and total cholesterol(TC); the high density lipoprotein cholesterol(HDL-C) and the low density lipoprotein cholesterol(LDL-C) were determined with the direct eliminationmethod. In order to observe the coronary atherosclerotic degree, we used HP2500 type color Doppler ultrasound to measure carotid artery intima-media thickness(IMT) of all subjects. Risk factors and atherosclerotic parameters of two groups were compared with the independent-samples T test statistical analysis and analyse the correlation between serum hs-CRP level and other risk factors and coronary heart disease with several factors logistic regression analysis.Results Compared between the basic medical history and biochemistry parameters within coronary heart disease group and control group, we found that the percentage of smoking, hypertensions and diabetes mellitus were 35.3%, 32.4% and 26.5% respectively, which were significantly higher in coronary heart disease group than that of control group (P<0.01) ; the serum level of FBG, TG and LDL-C were (6.28±3.20 mmol/L), (2.22±2.45mmol/L) and (2.91±1.67mmol/L) respectively, which were increased obviously in coronary heart disease group (P<0.01); the serum level of TC was (4.72±1.75 mmol/L) and was higher in coronary heart disease group than that of control group (P<0.05); the serum level of HDL-C decreased compared with the control group and the level was (1.21±0.52 mmol/L), but the level of coronary heart disease group was similar to that of control group (P>0.05). The compared results of hs-CRP and IMT showed that, the serum level of hs-CRP and the thickness of IMT were significantly higher in coronary heart disease group than these of control group(5.64±1.83 vs 0.89±0.51 mg/L , P<0.01 ; 1.62±0.35 vs 0.83±0.21 mm,P<0.01), and there were positive correlation between the serum level of hs-CRP and the thickness of IMT( r =0.628 , P<0.01). Compared among the coronary heart disease patients with different atherosclerotic degree, we found that the serum hs-CRP level was increased step by step following the stable angina pectoris, the accelerated angina pevtoris to the acute myocardial infarction, and the serum hs-CRP level was significantly higher in the accelerated angina pevtoris group and the acute myocardial infarction group than that of the stable angina pectoris group . Logistic regression analysis showed that smoking, hypertension, diabetes mellitus and blood lipid abnormality were risk factors of coronary heart disease, but the serum hs-CRP level might be a new and important riskfactor to affect carotid atherosclerosis during the development of coronary heart disease(β=2.042).Conclusion The serum hs-CRP level is a direct and important risk factor, other risk factors of coronary heart disease include smoking, hypertension, diabetes mellitus and bood lipid abnormality. The serum hs-CRP level is significantly higher in coronary heart disease patients than that of normal group, the serum hs-CRP level is related with the different types of coronary heart disease, which suggests that the serum hs-CRP level is helpful to diagnose and follow up these patients.