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CRP Predicts Inducible Ischemia in Stable Coronary Disease

Inflammatory processes appear to be involved in inducible ischemia.

High levels of C-reactive protein (CRP), a measure of inflammation, are associated with increased risk for cardiovascular events in apparently healthy people. Now, new data suggest a strong relation between CRP levels and inducible ischemia in patients with coronary atherosclerosis.

California researchers determined CRP levels in 118 subjects with inducible ischemia by stress echo and in 111 subjects without such ischemia. Overall, patients in the highest quintile of CRP levels (>0.38 mg/dL) were significantly more likely to exhibit inducible ischemia than were patients with lower CRP levels (75% vs. 45%). However, this association was strongest in subgroup analyses of patients who did not receive ß-blockers (93% vs. 42%) or statins (94% vs. 44%) and was not significant in subgroup analyses of patients who did receive either or both of these medications.

Comment: These data suggest that elevated CRP levels are associated with inducible ischemia, as well as with the previously documented increased risk for cardiovascular events. Statin or ß-blocker therapy weakened this association, presumably by blocking inflammatory processes that are important for development of ischemia or by reducing the severity of ischemia and subsequent inflammation.

— Kirsten E. Fleischmann, MD, MPH

Published in Journal Watch General Medicine February 25, 2003

Citation(s):

Beattie MS et al. C-reactive protein and ischemia in users and nonusers of ß-blockers and statins: Data from the Heart and Soul Study. Circulation 2003 Jan 21; 107:245-50.

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