Title: Study on Role of C-Reactive Protein as a Prognostic Marker in Diabetic and Non-Diabetic Patients with acute Myocardial Infarction

Authors: Dr P. Amulya, Dr B. Ashok Babu, Dr M. Madhusudhana Babu, Dr K. Sudheer

 DOI: https://dx.doi.org/10.18535/jmscr/v11i2.22

Abstract

Introduction: Atherosclerosis is associated with low grade inflammation of vascular structure and endothelial cells. Studies have shown that CRP, a marker for inflammation is augmented in MI, Stroke and Coronary Artery Disease. Type 2 Diabetes is an independent risk factor for atherosclerosis. It is considered to be a state of low grade inflammation. CRP levels have been reported to be augmented in diabetic patients.

Aims & Objectives: This study is aimed at assessing the role of CRP in patients with MI and at comparing the results between diabetic and non -diabetic patients. The aim of the study is to determine the CRP level at the time of admission as a marker of hospital mortality and morbidity in both diabetic and non-diabetic patients who had acute myocardial infarction.

Materials and Methods: The study was conducted on 100 patients (50 Diabetics & 50 Non-Diabetics) in Great Eastern Medical School & Hospital, Ragolu, Srikakulam, Andhra Pradesh with acute Myocardial infarction. The patients were divided into two groups, 50 Diabetics and 50 Non-Diabetics. Venous blood sample was collected on admission and sent for investigations. Cut-off of 7mg/l for C-reactive protein on admission is taken for patients with acute myocardial infarction. Statistical evaluation was performed using suitable statistical methods.

Results: The study demonstrated that CRP levels on admission were higher in both Diabetic patients and non-diabetic patients with acute MI. The CRP levels were higher in diabetics than non-diabetics. The diabetic patients with higher CRP level had higher incidence of mortality and morbidity as compared to non-diabetic patients with acute MI.

Conclusion: This study found that CRP on admission is a strong predictor for hospital morbidity and mortality in both diabetic and non diabetic patients with acute myocardial infarction. Diabetic patients presented with higher CRP levels compared with those in non diabetic patients with acute myocardial infarction. CRP may serve as marker in predicting the hospital mortality in patients with acute myocardial infarction.

References

  1. Lawlor DA, Harbord RM, Timpson NJ, et al. The association of C-reactive protein and CRP genotype with coronary heart disease: findings from five studies with 4,610 cases amongst 18,637 participants. PLoS One 2008; 3:e3011.
  2. Elliott P, Chambers JC, Zhang W, et al. Genetic Loci associated with C-reactive protein levels and risk of coronary heart disease. JAMA 2009; 302:37.
  3. Fauci AS, Kasper DL, Hauser SL, Lango DL, Jameson JL, Loscalzo. Ischemic heart disease. In - Harrison's principles of internal medicine, 21st Ed,: Mc Graw Hill; 2012.1998.
  4. Dev BP, Siddarth NS, M Paul A, Aspi RB, Sandhya AK, Dilip RK, et-al. Stelevation myocardial infarction. In API textbook of medicine, 8 edition,2008.520
  5. WHO(2002),Health situation in the South East Asia Region 1998-2000,New Delhi
  6. Lau DC, Dhillon B, Yan H, Szmito PE, Verma S. Adipokines: molecular links between obesity and atherosclerosis. Am J Physiol Heart Circ Physiol 2005; 288(5):H2031-41.
  7. Pai JK, Pischon T, Ma J, Manson JE, Hankinson SE, Joshipura K, Curhan GC, Rifai N, Cannuscio CC, Stampfer MJ, Rimm EB. Inflammatory markers and the risk of coronary heart disease in men and women. N Engl J Med 2004;351:2599-2610.
  8. Otter W, Kleybrink S, Doering W, Standi E, Schnell O. Hospital outcome of acute myocardial infarction in patients with or without diabetes mellitus. Diabet Med 2004;21:183-187.
  9. Kuller LH, Tarcy RP, Shaten J, Meilahn EN. Relation of C-reactive protein and coronary heart disease in the MRFIT nested case control study. Am J Epidemiol 1996; 144: 537-47.

Corresponding Author

Dr P. Amulya