engleski

High-sensitivity C-reactive protein as a biomarker of coronary arthery disease: elevated levels in patients with upper gastroduodenal lesions

Introduction: It is important to evaluate possible biomarkers of Coronary artery disease (CAD), especially in early stage of the disease which implies possible early diagnosis and treatment. High-sensitivity C-reactive protein (hsCRP) represents a biological marker of CAD with possible implications in pathogenesis of the disease. Aim: The aim of our study was to determine is there any significant difference in hsCRP levels between CAD and nonCAD patients, depending on the extent of upper gastrointestinal (gastroduodenal) lesions (UGIL). Patients and methods: We enrolled 163 CAD patients and 116 controls (nonCAD patients). All patients undergone upper endoscopy and were classified in subgroups according to the degree of UGIL by using modified Lanza score - score 0 meaning no UGIL, and score 5 meaning gastric or duodenal ulcer. Statistical methods used were Spearman’s coefficient of rank correlation (rho) and Student’s t-test, and when comparing subgroups according to Lanza score between themselves we used Mann-Whitney and Wilcoxon’s test. Serum hsCRP was determined by using standard laboratory CRP Latex and CRP Latex Calibrator (HS) set by Beckman-Coulter. Cut-off value of hsCRP was set at 15 mg/L. Results: In the group of nonCAD there was no statistically significant difference in hsCRP levels between subgroups of patients according to Lanza score (p=0, 4478). However, in the group of CAD we found statistically significant difference between subgroups of patients according to Lanza score (p<0, 0001) meaning that CAD patients without UGIL (Lanza score 0) had significantly lower levels of hsCRP compared to CAD patients with gastric or duodenal ulcer (Lanza score 5). When comparing CAD and nonCAD patients in subgroups according to Lanza score, we found in each subgroup significant difference in hsCRP levels, meaning that CAD had statistically higher hsCRP level compared to nonCAD patients (in each Lanza score subgroup 1-5, p<0, 05). Discussion: High sensitivity CRP has important pathophysiological role in development of CAD and is already recognized as one of indicators of increased cardiovascular risk. We found that hsCRP positively correlated with UGIL severity in CAD patients – CAD patients with gastric or duodenal ulcer had significantly higher levels of hsCRP compared to CAD patients without peptic ulcer disease. According to results of our study, we found no such difference in the group of nonCAD patients when comparing them according to UGIL severity. Conclusions: It seems possible that CRP plays a significant pathophysiological role in CAD patients with UGIL comorbidity. It remains to determine the meaning of these results - does UGIL represent additional impact on stratification of cardiovascular risk by increasing hsCRP

hsCRP; coronary artery disease; biomarkers; upper gastrointestinal lesions; coronary artery disease

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