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Introduction: C-reactive protein (CRP) has come to prominence in the cardiovascular field with the inflammatory hypothesis of atherosclerosis. Many studies evaluated the role of CRP as a prognostic marker in ST-segment elevation myocardial infarction (STEMI). The aim of our work was to study the relation between admission CRP level and the angiographic severity of coronary artery disease in patients presenting with acute ST elevation myocardial infarction. Patients and Methods: Admission CRP was measured for 100 STEMI patients before primary percutaneous coronary intervention (PCI). Complexity of coronary lesion was assessed using both Syntax score and thrombolysis in myocardial infarction (TIMI) flow. Results: Syntax score was significantly higher in the 3rd CRP tertile (20.24 ± 5.6 and P = 0.000), TIMI 0 flow was the highest in the 3rd tertile (24% and P = 0.001). We found a significant positive correlation between Syntax score and CRP and a significant negative correlation between CRP and TIMI flow (P = 0.001 and 0.005, respectively). Receiver operating characteristic curve constructed to determine the sensitivity of admission CRP to determine intermediate to high risk SYNTAX score showed a level =8.4 mg/dl as 71% sensitive (area under the curve [AUC] =0.65 and a P = 0.02) and an admission CRP of =4.8 mg/dl to be 81% sensitive in determining no or faint antegrade flow (TIMI 0 and 1) (AUC = 0.71. P =0.001). Conclusion: There is a strong positive correlation between admission CRP and the syntax score and TIMI flow in STEMI patients undergoing primary PCI, thus adding CRP to the risk scoring systems used to assess STEMI patients before PPCI can help better risk stratify patients before going into the cath laboratory. [ABSTRACT FROM AUTHOR]

BACKGROUND: Coronary artery calcification (CAC) is an important marker of total burden of coronary atherosclerosis. Furthermore, it is a measure of subclinical atherosclerotic disease that correlates well with the cardiovascular risk. The aim of our study was to determine the role of the different lipid parameters in prediction of calcification in coronary arteries using multidetector computed tomography (MDCT). METHODS: This study was conducted on 120 patients presenting to the clinic with typical or atypical chest pain or dyspnea on exertion, or equivocal stress test results along with standard cardiac risk factors; they all underwent computed tomography (CT) coronary angiography. A total calcium score was determined by summing individual lesion scores from each of our anatomic sites: left main (LM), left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA). The amount of calcium present in the coronary arteries was scored according to Agatston score, and patients were divided into 2 groups based on absence (group I) and presence (group II) of CAC. Clinical characteristics, lipid ratios, and a full blood count were calculated and compared between both groups. RESULTS: Mean and standard deviation (SD) for age of group I was 52.4 ± 8.4 years, while that of group II was 53.7 ± 7.9 (P > 0.005). Patients in group II had a higher total cholesterol (TC), low-density lipoprotein (LDL), TC/high-density lipoprotein cholesterol (HDL-C) and LDL/HDL-C ratio, and lower HDL levels. TC/HDL ratio and LDL/HDL ratio were found to be good predictors of calcium using a regression analysis model. Finally, at a cut-off value of ≥ 3.108, LDL/HDL ratio showed a sensitivity of 58.8% and specificity of 84.6% in prediction of coronary calcium, while TC/HDL ratio ≥ 4.742 showed a sensitivity of 60.3% and specificity of 88.5%. CONCLUSION: Amongst the different lipid parameters, TC/HDL-C and LDL/HDL ratio were found to be good predictors of presence of CAC in coronary arteries. [ABSTRACT FROM AUTHOR]