ABSTRACT
Many patients who present with acute coronary syndromes have no apparent clinical risk factors. This finding points out the need for markers that better predict cardiovascular risk. Evaluation of high sensitivity C-reactive protein [hs-CRP] serum levels as well as some other inflammatory markers such as von Willebrand factor [vWF] and erythrocyte sedimentation rate [ESR] in patients with acute myocardial infarction [AMI]. This study was performed on twenty five patients with AMI [21 males and 4 females], and twenty five apparently healthy persons as a reference group [20 males and 5 females]. Patients were subdivided into two groups: Group I: included ten patients presenting more than 6 hours after the onset of symptoms.Group II: included fifteen patients presenting within the first 6 hours after the onset of symptoms. Clinical examination and the following laboratory investigations were done: [A] Routine investigations: blood picture, serum glucose, kidney function tests, prothrombin time and concentration, liver function tests, lipogram, ESR, creatine phosphokinase [CPK] and lactate dehydrogenase [LDH] [B] Special Investigations: hg-CRP, vWF-Ag, and Troponin I. LDH, CPK as well as both ESR-1st h and 2nd h values showed elevations in both patient groups compared to controls [p<0.001], but there was no significant difference between the two patient groups: CRP values showed significant elevation in both patients groups compared to controls [p<0.001], and the elevation was significantly pronounced in group I compared to group II [p<0. 001]. Both plasma vWF-Ag and serum Troponin I values showed significant increase in both patient groups compared to controls [p<0.001], but there was no significant difference between the two groups. Significant positive correlations between vWF and CPK [r=0.646, P < 0.001] and between vWF and LDH [r = 0.507, P < 0.01] were found in AMI patients. Both hs-CRP and vWF are significantly high in patients with AMI. Thus, they can be considered as valuable markers of AMI that can aid in the diagnosis of AMI. Consistent and significant elevation of hs-CRP within the first 6 hours in patients developing myocardial infarction, which is attributed to chronic inflammatory atherosclerotic process rather than myocardial damage, suggest that hs-CRP has a potential predictive value for MI