Assessment of three inflammatory markers of cardiovascular diseases with a special accent on C-reactive protein.

Background:  Elevated levels of CRP, myoglobin and creatine kinase are always associated with pathological changes and hence their values give useful information for exact diagnosis and therapy. They are helpful in monitoring the inflammatory processes and associated diseases. Aim:  The aim of this study was to determine the usefulness and practical value of application of CRP detection by comparing it with the results obtained for the classical enzymes – markers of myocardial damage, myoglobin and creatine kinase isoenzyme MB (CK-MB) in pts with acute coronary syndrome (ACS), pts with chronic coronary artery disease (CAD) and in healthy individuals. Material and Methods:  Sera were taken from a total of 152 individuals (78.9% males, 21.1% females, mean age 61.87 ± 10.32 years). The subjects were divided in three groups: 63 pts with ACS; 52 pts CAD and a group of 36 conditionally healthy individuals. Analysis of patients’ sera for presence of markers for myocardial damage: myoglobin, CK-MB along with determination of CRP level was done on the Immulite system, DPC (Diagnostic Products Corporation), Los Angeles, USA. Results:  Comparison of examined biomarker’s values in pts divided according to diagnosis showed statistically significant higher levels in patients with ACS vs. others. As for biomarker’s cut-off values, out of all CK-MB ³ 5.7 ng/mL was found in 34 (53.1%) pts with ACS with significant difference among the groups in favor of its higher values in pts with ACS (p=0.0001). Out of all, myoglobin ³ 25 ng/mL was found in 54 (84.4%) pts with ACS without significant difference among the groups. As for CRP, value of ³ 3 mg/L was found in 39 (60.9%) pts with ACS and there was significant difference among the groups in favor of higher values in pts with ACS (p=0.001). There was significant positive correlation among the levels of examined three biomarkers: CK-MB in correlation to myoglobin (r=0.460; p= 0.0001) and to CRP level (r=0.204; p= 0.009), as well as myoglobin to CRP level (r=0.218; p= 0.005). Conclusion:  We could conclude that determination of CRP levels is a valid test for detection of acute coronary artery disease in addition to the classical, standard markers for myocardial damage.