Along with CRP levels in plaque and in blood serum, the overall plaque burden on the heart, total cholesterol, diabetes, smoking history, and body mass index was determined for each subject. The number of thin-cap plaques per heart also was determined. These plaques, also called atheroma, are composed of cholesterol, lipid materials and lipid macrophages large cells within artery walls that ingest other microorganisms, cells and foreign matter. Those with thin caps are the least stable and most likely to rupture unexpectedly. CRP levels were compared and subjects were stratified into highest and lowest quintiles.

Its exciting to think we may be able to detect the culprit lesion that might kill a patient, explains Virmani. There are people walking around with high CRP levels who have no idea they are at risk because all the other signs appear normal. CRP is the only abnormality that gives rise to heightened risk of sudden death once factors such as pneumonia and other conditions that raise CRP levels are factored out.

The researchers found the median CRP was 3.2 micrograms per milliliter (ug/mL) in acute plaque rupture; 2.9 ug/mL in plaque erosion; 2.5 ug/mL in stable plaque; and 1.4 ug/mL in the control group.

In the study, 52.8 percent of people whose plaque had ruptured had serum CRP levels above 3 ug/mL, compared with 20 percent of controls. About 39 percent of people with eroded plaques had levels above 3 ug/mL, and 35 percent of individuals with stable plaque had levels above 3 ug/mL.

Previous studies have shown that baseline plasma levels of circulating CRP can predict risk of future stroke and heart attacks. In unstable angina, elevated CRP levels are associated with poorer disease pr
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
15-Apr-2002