Impact of the metabolic syndrome on high-sensitivity C reactive protein levels in patients with acute coronary syndrome

• Published in: Atherosclerosis 2009-12, Vol.207 (2), p.591-596
• Main Authors: Kilic, Teoman, Jneid, Hani, Ural, Ertan, Oner, Gokhan, Sahin, Tayfun, Kozdag, Guliz, Kahraman, Goksel, Ural, Dilek
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - blood; Acute Coronary Syndrome - etiology; Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Body Mass Index; C-Reactive Protein - metabolism; Cardiology. Vascular system; Cardiovascular; Case-Control Studies; Coronary heart disease; Cross-Sectional Studies; Female; Heart; High-sensitivity C reactive protein; Humans; Inflammation Mediators - blood; Inflammatory response; Logistic Models; Male; Medical sciences; Metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - complications; Middle Aged; Odds Ratio; Risk Assessment; Risk Factors; Troponin - blood; Up-Regulation
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2009.05.035

Abstract Objective Underlying predisposition for a heightened inflammatory response is postulated as one of the mechanisms for elevated high-sensitivity C reactive protein (hs-CRP) levels in patients with acute coronary syndrome (ACS). It is unclear whether metabolic syndrome (MetS) may cause a predisposition for heightened hs-CRP response in patients with ACS. The aim of this study is to investigate the interaction between hs-CRP levels and presence of MetS in patients with and without ACS. Methods Two hundred and seventy-three consecutive patients presenting with a first ACS event and 261 MetS patients without any ACS event were included to the study. The study participants were divided into three groups as MetS (+) ACS (−) [ n = 261], MetS (−) ACS (+) [ n = 110], and MetS (+) ACS (+) [ n = 163]. Median levels of hs-CRP were compared between and within the three groups. Results Hs-CRP levels were lowest in MetS (+) ACS (−) subjects and highest in MetS (+) ACS (+) patients. Factors associated with hs-CRP levels were troponin elevation, presence of ACS, body mass index (BMI), and presence of MetS ( R2 = 0.26, p < 0.01). Predictors of elevated hs-CRP levels (>0.3 mg/dl) were the presence of ACS (OR = 3.6, 95% CI = 1.9–6.5, p < 0.01), presence of MetS (OR = 2.1, 95% CI = 1.0–4.0, p = 0.02), troponin elevation (OR = 5.7, 95% CI = 2.8–11.5, p < 0.01) and BMI (OR = 1.1, 95% CI = 1.0–1.1, p < 0.01). Conclusions The presence of MetS had an impact on the increase in hs-CRP levels observed with an ACS event in the study population. These findings suggested that a heightened baseline inflammatory status of MetS may predispose ACS patients to an augmented hs-CRP response.