A study on serum hs CRP as a risk predictor and its diagnostic and prognostic significance in acute coronary syndrome
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 5
Abstract
There has been an increasing incidence of coronary artery disease in India and a greater Rise is expected in next few years. coronary artery disease in Indians has been found to be more severe and widespread and have been found to be associated with serious complications and increasing mortality. Thus arises the necessity of a tool which act as a risk predictor,can assess the severity and prognosis of acute coronary syndrome also has value in diagnosis and management. The concentration of CRP ( 3mg/dl to >200mg/dl ) at which it is detectable in serum is not sensitive for the value required to determine the cardiovascular risk in otherwise healthy person. So modified technique have been developed which can detect hsCRP by hsCRP assay at a range( 0.2mg/l – 20mg/l ) where it can determine cardiovascular risk in otherwise healthy person and have diagnostic and prognostic significance in ACS. hsCRP is an acute phase reactants, whose level are increased proportional to the extent of inflammation. hsCRP is elevated in AMI and levels correlate with total infarct size in AMI and with prognosis and also has role in management. This study is done to measure the hsCRP levels in ACS and to determine its significance for risk prediction and it's diagnostic, management and prognostic significance.We studied 100 patient of acute coronary syndrome ( STEMI and UA/NSTEMI ) admitted in department of Medicine RIMS Ranchi with signs and symptoms of acute coronary syndrome during the time period of 1 year on the basis of history ,clinical examination ,ECG, echocardiography and TMT findings. The serum hsCRP levels were measured at admission by in vitro quantitative method. Patient were also followed up in hospital and also after discharge.There were 75 males and 25 females. Mean age for male was 49.06 years and for female was 60.4 years. STEMI was seen in 52 patients and 48 patient had UA/NSTEMI.hsCRP levels were elevated in 62 patient out of which 46 patients met with complication and among 38 patient in whome CRP were not elevated only 4 patients met with complication.Raised hsCRP levels are markers of adverse outcome. plasmahsCRP levels on admission serves to identify high risk patients in the settings of ACS . The effective list stratification provided maybe of the specific value for early therapeutic decision making and patient treatment in patients presenting with ACS.hsCRP levels were high in STEMI patients in comparison to UA/NSTEMI and also high hsCRP level were associated with poor prognosis.
Authors and Affiliations
Dr Divakar Kumar, Dr C. B Sharma
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