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(Circulation. 1999;100:e65.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

C-Reactive Protein, Serum Amyloid A Protein, and Coronary Events

Robin P. Choudhury, MA, MRCP; Francisco Leyva, MD, MRCP

Department of Cardiology, Royal Brompton Hospital, London, UK

	Introduction

 
To the Editor:

Ridker et al¹ examined C-reactive protein (CRP) and serum amyloid A protein (SAA) in patients from CARE, a secondary-prevention study of pravastatin after myocardial infarction. They observed that the median plasma concentrations of CRP (0.31 versus 0.28 mg/dL; P=0.05) and SAA (0.34 versus 0.28 mg/dL; P=0.006) were significantly higher among those in whom coronary events occurred than in age- and sex matched controls. They concluded that the plasma concentrations of CRP and SAA predict the risk of recurrent coronary events among patients with prior myocardial infarction.

However, the matching of the subjects and controls was not complete. The group in whom events occurred contained a significantly higher proportion of diabetic patients (22.3% versus 9.7%; P=0.001), who are known to be at high risk of coronary events.²

We investigated 23 diabetic patients (mean age 62.0 years, SD 10.3, range 42 to 76; 18 men, 5 women) and 33 nondiabetic controls (61.3 years, SD 9.2, range 39 to 86; 31 men, 2 women), all with similar symptoms of stable angina and angiographically confirmed coronary disease. There were no significant differences between the groups in the mean number of affected coronary vessels (2.47 in diabetic and 2.21 in controls) or in history of hypertension, smoking, total cholesterol, cholesterol subfractions, or use of statins and aspirin. However, we found that the diabetic patients had significantly higher plasma concentrations of both CRP (mean, SD of log values 2.78, -0.60, +0.77 versus 1.52, -1.00, +2.92 mg/L, P=0.05) and SAA . . . [Full Text of this Article]

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