P189	High-sensitivity C-reactive protein predicts the presence of coronary artery disease in non-selected, consecutive patients undergoing coronary angiograpy.
H.F.Alber, A.Suessenbacher, J.Doerler, A.Ladurner, J.R.Kurz, W.Dichtl, M.Frick, O.Pachinger, F.Weidinger
Division of Cardiology, Innsbruck Medical University, Innsbruck, AT.

Background: Inflammation is an inherent process in coronary artery disease (CAD) measurable by levels of high-sensitivity C-reactive protein (hsCRP). HsCRP may be used for the risk stratification in primary and secondary prevention. Whether CRP is actively involved in atherogenesis, reflects risk factor burden and/or functions as a marker for the presence of CAD is still debated. The aim of this study was to investigate the correlation of hsCRP levels with the severity of CAD and risk factors in consecutive patients undergoing coronary angiography. Methods: 1999 consecutive patients undergoing coronary angiography were prospectively analysed. Patients with valvular or congenital heart disease and patients with acute coronary syndromes were excluded. Cardiovascular risk factors were assessed by routine laboratory and questionnaire. HsCRP was determined by Latex agglutination assay. Severity of CAD was graded by visual estimation of lumen diameter stenosis. Significant stenoses were defined as lumen diameter reductions ≥50% in at least one major coronary vessel. Coronary angiograms were graded as 1-, 2- or 3-vessel disease (VD) or as non-CAD. Results: HsCRP levels were higher in patients with CAD (n=1527) compared to non-CAD patients (n=472) (1.32±2.63 vs. 0.78±1.97mg/dL; p<0.0001), but were not different between 1-VD (n=850), 2-VD (n=335) and 3-VD (n=343). In logistic regression analysis including age, sex, total and HDL cholesterol, diabetes, smoking, hypertension and prior statin use as covariates, hsCRP was independently associated with the presence of CAD (OR 1,12, p<0.05). The total number of risk factors was not associated with hsCRP levels. Conclusion: In this large consecutive patient cohort, hsCRP is independently associated with the presence of CAD, but is not related to severity of CAD or total number of risk factors. This data suggest that hsCRP is a marker for the presence of CAD, but seems not to reflect total risk factor burden.

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