C-reactive Protein For Ischemic Heart Disease

Ischemic heart disease (IHD) or myocardial ischemia is a disease where blood supply to the heart muscle gets reduced. This occurs generally due to a coronary artery disease, termed atherosclerosis of the coronary arteries. Smoking, hypercholesterolemia or high cholesterol levels, diabetes, hypertension and old age are some of the risk factors of the disease. IHD is more common in men and can be hereditary. Symptoms of a stable IHD are angina (chest pain due to exertion) and limited exercise tolerance. Symptoms of unstable IHD include a rapidly worsening angina where chest pain occurs even while resting. An electrocardiogram, blood tests (cardiac markers), cardiac stress testing or a coronary angiogram are necessary for diagnosing IHD.

Treatment of IHD depends on the symptoms and risk factors. Treatment can be through medication, percutaneous coronary intervention or angioplasty or coronary artery bypass surgery (CABG). IHD can be prevented to some extent and complications can be averted. A healthy diet, necessary medications for diabetes, cholesterol and high blood pressure are some of the ways of prevention.

C-reactive protein or CRP is a protein which is found in the blood during an inflammation. CRP is produced by the liver and fat cells or adipocytes and is a member of the pentraxin family of proteins. During an inflammation in the body the plasma concentration of IL-6 rises due to macrophages and adipocytes. As a result, the level of CRP rises dramatically. This acts as the first defense system against any kind of infection.

Since arterial damage occurs due to white blood cell invasion and inflammation within the wall, CRP can be used to check the risk of a heart disease. However, it cannot be a specific prognostic indicator. As per recent research, patients having an elevated level of CRP are at a risk of hypertension, diabetes and cardiovascular disease. A study has shown that patients in the highest quartile of trans fat consumption had CRP in the blood at about 73 per cent higher than those in the lowest quartile. However, some researchers say that CRP is only a moderate risk factor for cardiovascular disease. Others have proved that CRP can aggravate ischemic necrosis.

Many researchers are examining whether CRP can predict recurrent cardiovascular diseases in different settings. High levels of CRP in the blood have consistently shown recurrent coronary events in patients having an unstable angina and acute myocardial infarction (heart attack). Higher CRP levels also get associated with lower survival rates in such patients. Research also suggests that high levels of CRP can increase the risk of re-closing of an artery after it has been opened by balloon angioplasty.

Many researchers have conclusively proved that higher the CRP level in blood, higher is the risk of a heart attack. An association has been found between CRP, sudden cardiac death and peripheral arterial disease. Plasma levels of CRP have been associated with the risk of IHD. Experiments have shown that fibrin degradation products have effects on inflammatory processes and acute-phase protein responses. However, in multivariate analyses, conventional risk factors reduced the association strength between CRP and IHD. More research and experiments still needs to be done to find the exact connection between CRP and IHD.