Abstract 12645: Coronary Sinus Biomarker Assessments in Non-ST Elevation Acute Coronary Syndrome: Systemic or Local Cardiac Release of High Sensitivity C-Reactive Protein?
Introduction: High sensitivity C-reactive protein (hsCRP) is frequently elevated in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). However, controversy remains regarding the origin of hsCRP. Reported theories vary from a systemic increase in inflammatory status, to a more local process.
Purpose: To assess concentrations of hsCRP in patients with ongoing NSTE-ACS using multiple sampling sites, to enable measurement of systemic or local changes.
Methods: 46 Troponin positive NSTE-ACS patients with significant coronary artery disease were included. Systemic arterial and venous blood was obtained, and right sided catheterization was performed to sample blood from the coronary venous system (CVS). In suitable patients, an additional blood sample was collected from the culprit coronary artery distal to the culprit lesion. Six hours post procedure blood was obtained from the systemic venous circulation. hsCRP concentrations were compared between the sampling sites.
Results: The median hsCRP concentrations in the systemic arterial and venous blood were high and not significantly different. hsCRP concentrations in the CVS were significantly lower (table).The median hsCRP concentrations between blood collected from the culprit coronary artery distal to the culprit lesion and the systemic arterial circulation were not significantly different (4.56mg/L to 4.40mg/L, respectively, n=14; p=0.551). Systemic hsCRP concentrations six hours post procedure were significantly higher (5.66mg/L vs 4.86mg/L; p<0.001).
Conclusion: In this series of patients with ongoing NSTE-ACS a decrease in hsCRP from the systemic circulation to the CVS was observed. This observation, combined with similar concentrations proximal and distal to the culprit and higher systemic concentrations six hours post procedure favors an extracardiac source of hsCRP.
Author Disclosures: S.A. Damen: None. G.E. Cramer: None. W.R. Aengevaeren: None. T.J. Oude Ophuis: None. M.J. Fokkert: None. L.D. Dikkeschei: None. H. Dieker: None. H. Gehlmann: None. F.W. Verheugt: None. H. Suryapranata: None. M.A. Brouwer: None.
- © 2016 by American Heart Association, Inc.