Serum Low Density Lipoprotein and Serum High Sensitive C - Reactive Protein as a Diagnostic Markers for Acute Coronary Syndrome

摘要

Background: Acute coronary syndrome (ACS) remains the major cause of mortality and morbidity in the worldwide. Low density lipoprotein- cholesterol (LDL-C) level is a major risk factor for the development of ACS, and pathogenesis of atherosclerosis. Atherosclerosis is a multi-step disease and characterized by chronic low-grade vascular inflammation, which plays a role in its every stage from onset, progression and finally to plaque rupture then triggers ACS. Elevation of high Sensitive C-reactive protein (hs-CRP) is a strong and independent predictor of cardiovascular disease. The objective of this work was to evaluate the role of serum LDL-C and serum hs-CRP in patients with ACS. Patients and Method: The current study enrolled 45 patients with confirmed ACS and 30 apparently healthy persons of matching age and sex as control group. The patients were subdivided into three subgroups each one included 15 patients: Subgroup A: ST-segment elevation myocardial infarction (STEMI). Sub-group B: Non-ST-segment elevation myocardial infarction (NSTEMI), Subgroup C: Unstable angina pectoris (UAP). All patients and control groups were subjected to measurement of low density lipoprotein- cholesterol (LDL-C), high density lipoprotein- cholesterol (HDL-C), total cholesterol, triglyceride, highly sensitive CRP (hs-CRP), cardiac troponin I (cTnI), and creatine kinase-MB fraction (CK-MB), electrocardiography (ECG) and trans-thoracic-echocardiography. Results: There was highly significant increase of serum LDL-C and serum hs-CRP in group I as compared to group II (P=0.001) and significant increase of serum LDL-C ((P<0.05) and highly significant increase of serum hs-CRP (P=0.01) in STEMI and NSTEMI subgroups when compared to UAP subgroup and highly significant increase of serum LDL-C (P=0.005) and serum hs-CRP(P=0.003) in UAP sub-group when compared to group II . There was also, a positive significant correlation between serum LDL-C and both serum CK-MB and serum hs- CRP in all subgroups. Conclusion: Elevated serum LDL and hs-CRP may serve as markers of the severity of the disease which help evaluation and management of ACS patients