Document Detail

Elevated C-reactive protein levels and coronary microvascular dysfunction in patients with coronary artery disease.
MedLine Citation:
PMID:  15961409     Owner:  NLM     Status:  MEDLINE    
AIMS: It is still unknown whether elevated C-reactive protein levels are responsible for coronary microcirculatory dysfunction in patients with coronary artery disease (CAD). This study was aimed at evaluating the association between C-reactive protein levels and endothelium-dependent and endothelium-independent coronary blood flow (CBF) responses in non-culprit arteries of patients with CAD. METHODS AND RESULTS: We studied 28 patients (14 with normal and 14 with elevated C-reactive protein levels, >5 mg/L) with single-vessel disease and otherwise angiographically normal coronary arteries undergoing percutaneous transluminal coronary angioplasty (PTCA). CBF was measured in the non-PTCA vessel using an intracoronary Doppler guide wire and quantitative coronary angiography at baseline, after intracoronary infusion of substance P and of adenosine, and expressed as per cent change from baseline. The increases in CBF during infusion of substance P and of adenosine were lesser in patients with elevated than in those with normal C-reactive protein levels (34+/-22 vs. 61+/-34%, P=0.04 and 131+/-53 vs. 189+/-89%, P=0.03, respectively). Multivariable analysis identified elevated C-reactive protein level as the only independent predictor of reduced response to substance P (P=0.01) and adenosine (P=0.02). CONCLUSION: In patients with CAD, evidence of systemic inflammation is independently associated with endothelium-dependent and endothelium-independent coronary microvascular dysfunction, which, in turn, may be critical to precipitate myocardial ischaemia, in particular, in unstable patients.
Fabrizio Tomai; Flavio Ribichini; Anna S Ghini; Valeria Ferrero; Giuseppe Andò; Corrado Vassanelli; Francesco Romeo; Filippo Crea; Luigi Chiariello
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Publication Detail:
Type:  Journal Article     Date:  2005-06-16
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-30     Completed Date:  2006-03-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2099-105     Citation Subset:  IM    
Division of Cardiology and Cardiac Surgery, Università di Roma Tor Vergata, European Hospital, via Portuense 700, 00149 Rome, Italy.
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MeSH Terms
Adenosine / pharmacology
Analysis of Variance
Blood Flow Velocity / drug effects,  physiology
C-Reactive Protein / metabolism*
Case-Control Studies
Coronary Angiography
Coronary Artery Disease / blood*,  pathology,  physiopathology
Coronary Circulation / drug effects,  physiology
Coronary Stenosis / blood*,  pathology,  physiopathology
Endothelium, Vascular / physiopathology
Hemodynamics / physiology
Microcirculation / physiology
Microvascular Angina / blood,  physiopathology
Middle Aged
Substance P / pharmacology
Vasodilation / drug effects
Vasodilator Agents / pharmacology
Reg. No./Substance:
0/Vasodilator Agents; 33507-63-0/Substance P; 58-61-7/Adenosine; 9007-41-4/C-Reactive Protein

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