Serum fibrinogen and C-reactive protein levels predict major adverse cardiac events in unstable angina.

The aim of this study was to ascertain the relationship of raised serum levels of fibrinogen and C-reactive protein at admission with in-hospital major adverse cardiac events in patients with unstable angina and to delineate their angiographic morphology. This single centre, prospective study consisted of 192 patients admitted in an intensive coronary care unit of a large municipal hospital with final diagnosis of unstable angina. The clinical endpoints were: in-hospital recurrent angina, new myocardial infarction or cardiac death. Patients with elevated levels of serum fibrinogen and C-reactive protein at admission showed a significantly higher incidence of an in-hospital recurrent major adverse cardiac event (p = 0.001). The mean levels of these markers were also significantly higher in patients with an in-hospital cardiac event as compared to patients with an uneventful hospital stay (p = 0.001). At angiographic evaluation, patients with type B and type C lesions and intracoronary thrombus had significantly higher levels of these markers as compared to patients with type A lesions (p = 0.001). It is concluded that in patients with unstable angina, elevated levels of serum fibrinogen and C-reactive protein at admission indicate an adverse in-hospital outcome and a more complex coronary morphology. The elevated levels of these easily measurable serum markers can therefore be useful in risk stratification of patients with unstable angina.