Quantification of C-reactive protein, differential count and blood glucose in acute coronary syndrome
Keywords:Acute coronary syndrome, Blood glucose level, C-reactive protein, Differential count
Background: The study was done to investigate whether the raised levels of C-reactive protein (CRP), differential count and random blood glucose, besides echocardiogram, enhances the assessment process of acute coronary syndrome (ACS).
Methods: This prospective study was done on 100 patients with typical chest pain attending to the department of medicine at K.A.P.V Medical College and Hospital, Trichy during the period from 2015 to 2017. The serum was assayed on admission for CRP, differential count and random blood glucose. Correlation of these parameters with incidence of ACS was calculated.
Results: Male preponderance was seen in the study. Out of 100 patients, majority of about 60% of ACS patients had raised JVP. Elevated level of CRP was seen in 73% patients, 70% had elevated level of ejection fraction percentage. 71% had elevated level of WBC and 58% had elevated level of RBS. Statistically significant correlation was observed with the level of CRP (p=0.044), differential WBC count (p=0.037) and random blood glucose levels (p=0.001).
Conclusions: Our study indicates that elevated CRP levels, increased random blood sugars and leucocytosis in ACS patient are positively correlated with decreased ejection fraction. Hence, measuring the levels of these parameters will helps in identifying incidence of acute coronary syndrome without echocardiogram.
Tahhan AS, Hammadah M, Raad M, Almwaqqat Z, Alkhoder A, Sandesara PB, et al. Progenitor Cells and Clinical Outcomes in Patients With Acute Coronary Syndromes. Circulation Res. 2018;1565-75.
Kennon S, Timmis AD, Whitbourn R, C Knight C. C reactive protein for risk stratification in acute coronary syndromes? Verdict: unproven. Heart. 2003;89:1288-90.
Lindahl B, Toss H, Siegbah A, Venge P, Wallentin L. FRISC Study Group. Markers of myocardial damage and inflammation in relation to long-term mortality in unstable coronary artery disease. N Engl J Med. 2000;343:1139-47.
Sabatine MS, Morrow DA, de Lemos JA, Gibson CM, Murphy SA, Rifai N, et al. Multimarker approach to risk stratification in non-ST-elevation acute coronary syndromes. Circulation. 2002;105:1760-3.
Mueller C, Buettner HJ, Hodgson JM, Marsch S, Perruchoud AP, Roskamm H, et al. Inflammation and long-term mortality after non–ST elevation acute coronary syndrome treated with a very early invasive strategy in 1042 consecutive patients. Circulation. 2002;105:1412-5.
Cervellin G, Mattiuzzi C, Bovo C, Diagnostic algorithms for acute coronary syndrome-is one better than another? Ann Transl Med. 2016;4:193.
Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010;121:948-54.
Danaei G, Singh GM, Paciorek CJ, Lin JK, Cowan MJ, Finucane MM, et al. The Global Cardiovascular Risk Transition: Associations of Four Metabolic Risk Factors with National Income, Urbanization, and Western Diet in 1980 and 2008. Circulation. 2013;127:1493-502.
Deedwania P, Kosiborod M, Barrett E, Ceriello A, Isley W, Mazzone T, et al. Hyperglycemia and Acute Coronary Syndrome. Circulation. 2008;117(12):1610-9.
Wilby KJ, Elmekaty E, Abdallah I, Habra M, Al-Siyabi K. Blood glucose control for patients with acute coronary syndromes in Qatar. Saudi Pharmaceutical J. 2016;24(1):35-9.
Anand IS, Latini R, Florea VG, Kuskowski MA, Rector T, Masson S, et al. C-reactive protein in heart failure. Circulation. 2005;112(10):1428-34.
Stumpf C, Sheriff A, Zimmermann S, Schaefauer L, Schlundt C, Raaz D, Garlichs CD, Achenbach S. C-reactive protein levels predict systolic heart failure and outcome in patients with first ST-elevation myocardial infarction treated with coronary angioplasty. Arch Med Sci: AMS. 2017;13(5):1086.
Kennon S, Timmis AD, Whitbourn R, Knight C. C reactive protein for risk stratification in acute coronary syndromes? Verdict: unproven. Heart. 2003;89(11):1288-90.
Hoffman M, Blum A, Baruch R, Kaplan E, Benjamin M. Leukocytes and coronary heart disease. Atherosclerosis. 2004;172(1):1-6.
Murtagh BM, Anderson HV. Inflammation and atherosclerosis in acute coronary syndromes. J Invasive Cardiol. 2004;16(7):377.