C - REACTIVE PROTEIN CONCENTRATION IN PATIENTS WITH ISCHAEMIC HEART DISEASE .
Ychia Saddik MD and Osama EL-Shaer*MD
Internal Medicine and Clinical Pathology* Departments, Benfui Faculty of Medicine, Egypt.
Abstract
We have studied thirty patients with ischaeniic heart disease (IHD) to determine the diag¬nostic and prognostic value of quantitative estimation of C-rcactivc protein (CRP) in their sera . Patients were classified into three groups : acute myocardial infarction group (AMI), angina pectoris group (AP) and old myocardial infarction group (OMI) , (ten patients in each group). Ten normal healthy subjects were selected and represented the control group . Scrum CRP and serum enzymes (CPK, LDH & SGOT) were estimated for all patients and control groups. In acute myocardial infarction group, CRP was markedly increased in all patients and the peak levels were in the third post infarct day . In patients who showed good smooth recovery CRP showed a fairly fall, from its peak toward its normal values in the subsequent days (it is about in the 7jh. day from the onset of infarction). Scrum enzymes (CPK, LDH & SGOT ) showed similar pattern with different peak levels and times . In complicated cases CRP levels showed either persistent rise or secondary peak, correspond¬ing rise of scrum enzymes suggesting extension of myocardial infarction while correspond¬ing fall of these enzymes suggesting other complications as deep venous thrombosis and cmbolic manifestations . Also we found positive correlation between peak level of scrum CRP and peak levels of all the studied scrum enzymes (CPK, LDH and SGOT). CRP lev¬els in angina pectoris and old myocardial infarction groups were nearly within normal range or slightly changed from normal, and statistically non significant when compared to nor¬mal control group, and there was no correlation between their levels and any of scrum en¬zymes (CPK, LDH and SGOT).
We recommend routine serial estimations of CRP in patients with acute chest pain as it represents an additional useful and sensitive laboratory test not only for the diagnosis of myocardial infarction but also for early detection , differential diagnosis and evaluation of intercurrent immediate post infarct period complications, all other conditions that affect scr¬um CRP concentration must be excluded before c.g strcptococcal infection and any other in¬fections, surgery and collagen diseases.
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