Clinical Significance Of High Sensitive C-reactive Protein In Patients With Unstable Angina

Unstable angina is a type of coronary heart disease which has severe pathogenetic condition and is easy to develop to acute myocardial infarction or sudden death. Finding a convenient and uninvasive check method which is used to judge the risk and prognosis in patients with unstable angina is very important , in order to early prevention and intervention. CRP is one of the acute phase reaction protein and sensitive inflammatory marker. High sensitive Oreactive protein (hs-CRP), which is known as having the most close relationship with the atherosclerosis. The difference between the hs-CRP and the traditional detection is detecting the little change of CRP in the normal range low level.It is possible not only a chronicity inflammatory marker but also straight participat in atherosclerotic process , which can reinforce the competent of forecasting prognosis, The predictive value of hs-CRP is significant higher than the indexs related with traditional risk factors or other new found indexs. Already investigation indicate that hs-CRP is a independent dangerous factor of CAD. Thisinvestigation will provide more theory basement in order to choose high risk patients and intervention treatment, by analyzing the dependability of hs-CRP with the traditionary risk factor related indexs such as blood fat , BMI in the process of unstable angina, but also by the significance of hs-CRP with Braunwald classification, ECG, heart ultrasound, carotid artery ultrasound in the unstable angina prognosis . The diagnose of the selected UA cases all consistent with the diagnostic criteria of unstable angina published by the ACC/AHA 2000, including angina, aggravate angina of effort, spontaneous angina, postinfarction angina pectors, excluding variability angina. According to Brounwald .class Ⅰ 21cases, class Ⅱ lOcases, class Ⅲ 9 cases. All cases empty stomach vein blood were checked for hs-CRP, TG, TC, HDL-C, LDL-C and calculating BMI=body mass /body highs square. In the hospital admission period the patients had the ECG , carotid artery ultrasound IMT and the heart ultrasound .After the admission the UA patients were administrated with aspirin enteric coated tablets , nitrates, β-receptor blockers or Ca channal blockers, at the same time add the statins atorvastatin calcium ,post discharge the UA patients were followed up three months , reviewing the occurrence of obduracy angina, acute myocardial infarction and sudden death due to heart failure. The control group were the medical staffs received physical health examination in our hospital. The level of hs-CRP in UA group was (4. 72 ± 1. 35)mg/l, the control group was (1. 67±1. 38)mg/l, the difference has signficance sense, (P<0.05) . IMT of the UA group was (1.04 ± 0.23) mm, the control group was (0.76 ± 0.08) mm, (P<0. 05) . The age, TG, TC, HDL-C, LDL-C, BMI between the two groups has no significant difference. Conduct hs-CRP as variable , compare with age, BMI, IMT, TC, TG, HDL-C, LDL-C, Brounwald classification , ECG abnormality change and heart ultrasound abnormality , one by one based on spearman rank correlation analysis, fiding that BMI, TC, IMT,Brounwald classification ,ECG abnornality change and heart ultrasound abnormality has predominance positive correlation with hs-CRP; HDL-C has negative correlation with hs-CRP. In the selected patients , there were 13 cases that had occurred end point events(32.5%), including 1 case of sudden death due to heart failure(2. 5%), 3 cases of acute myocardical infarction (7. 5%), 9 cases of obduracyangina(22. 5%). The levels of hs-CRP in the occurred heart end point event group (A group) was higher than the nonoccured group(B group), furthermore , all the cases in group A were Brounwald Ⅱ,Ⅲ, its proportion were higher than group B obviously. Simultaneous the cases which had ECG ultrasound abnormal change in group A were higher than group B;both have the statistical significance, (P< 0.05) .In the group which had higher hs-CRP level (≥ 3mg/l), its proportion of Brounwald Ⅱ,Ⅲ was higher than the group which has lower hs-CRP level < 3mg/l , the difference has significant sense (P<0. 05). The indidence rate of the end point event in two groups has significant difference (P<0.05) . By the spearman correlation analysis , fiding that it has a better dependability between the heart end point event with the level of hs-CRP,IMT,Brounwald classification,ECG abnornality change and heart ultrasound abnormal change. Conclusion: 1. The level of hs-CRP in UA group was higher the control group , the difference has signficance sense, P<0. 05) . 2. There was a positive correlation between hs-CRP with BMI, TC, IMT, Brounwald classification , ECG abnornality change and heart ultrasound abnormality; and negative correlation...