There is a direct correlation between the level of a protein called CRP in a patient's blood and his chances of recovering from a heart attack caused by a blocked coronary artery, according to a new study by researchers from the Technion and Rambam Medical Center.
The researchers found that of patients with a high level of CRP (C-Reactive Protein), 22 percent died within 30 days of suffering a heart attack. This is almost eight times higher than the mortality rate among patients with a low CRP level.
"In modern cardiology, we are searching for markers that can help us understand the patient's situation. This protein serves as a clear and unequivocal marker," said Professor Haim Hammerman of the Technion's faculty of medicine, who headed the research team, in explaining the finding's importance. The results of the study were published yesterday in The American Journal of Medicine.
CRP has recently been the focus of numerous studies, as there appears to be a correlation between a person's CRP level and the likelihood that he will suffer heart problems. "Some have even compared it to `bad cholesterol' with regard to the information it gives a person about his situation," Hammerman said.
The protein is generally released as the result of an inflammation.
However, noted Hammerman, the presence of the protein "doesn't tell us where in the body there is an inflammation; it is nonspecific. All it tells us is that there is an inflammation somewhere."
In recent years, researchers have discovered that blocked coronary arteries often cause inflammation of the heart. Therefore, Hammerman's team decided to investigate whether it also resulted in high CRP levels, and whether this had any implications for the patient's recovery rate.
The researchers examined 448 patients who suffered heart attacks due to a blocked coronary artery by taking blood from them within 12 to 24 hours after the attack occurred and testing it for CRP. The patients were divided into three categories: those with a low CRP level (less than 6.9 milligrams per liter of blood), those with a medium level (6.9 to 22.3 milligrams per liter) and those with a high level (more than 22.3 milligrams per liter). The researchers then followed the patients' progress for 30 days.
At the end of the 30 days, only 3 percent (4 patients) of those with a low CRP level had died, compared to 10 percent (15 patients) of those with a medium level and 22 percent (33 patients) of those with a high level. Furthermore, only 8 percent of those with a low CRP level suffered from insufficient blood flow through the heart, which is considered a serious complication, after the attack, compared to 44 percent of those with a high CRP level.
The strength of the results has led the researchers to wonder whether CRP is merely an indicator or whether it also plays an active role in impeding the patient's recovery. However, Hammerman said, there is not yet enough information to answer this question.
Yet even without this information, he stressed, the clear correlation between CRP level and risk level could provide doctors with an important additional tool for deciding on treatment. "If we know that a certain patient has a high protein level, we might choose a more aggressive treatment than we would have chosen had we not had this information," he explained. "But this matter requires further research."
Hammerman added that the test for CRP level is neither expensive nor complicated, and could therefore easily be made standard procedure for all heart attack patients.
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