European Journal of Cardiovascular Medicine

Background: High sensitive C reactive protein levels (hs-CRP), a classical sensitive systemic inflammatory marker, are associated with short term and long term mortality in patient with acute coronary syndrome (ACS). Aim: The aim of this study was to find out the correlation of hs-CRP with coronary artery disease severity assessed by SYNTAX score (SX score) in patients with acute myocardial infarction (AMI). Methods: This cross sectional study was conducted in the Department of Cardiology, National Heart Foundation Hospital & Research institute, Dhaka, over a period of one year from 01/01/22 to 31/12/22. A total of 165 patients with AMI who underwent coronary angiography (CAG) selected purposively were included after considering inclusion and exclusion criteria. Study population were categorized equally into 3 tertiles according to available hs-CRP values. 33% (n=55) patients were in group A and their hs-CRP level was ≤25.3 mg/L; 33%(n=55) patients were in group B and their hs-CRP range was 25.4-70.6 mg/L; 33% (n=55) were in group C and their hs-CRP level was ≥70.7 mg/L. Baseline characteristics, biochemical variables, left ventricular ejection fraction(LVEF) and coronary artery disease severity by SYNTAX score were then compared among three groups. Results: Patients with raised level of           lllhs-CRP (Group C tertile) had significantly higher SYNTAX score compared with other    two tertiles [mean (±SD) SYNTAX score was 9.0 ± 4.3; 16.2 ± 5.6; 29.7 ± 8.3 respectively; (p <0.05)]. Strong positive correlation (r=0.885) was found between hs-CRP and SYNTAX score, which was statistically significant (p ˂0.05). Logistic regression analysis showed that hs-CRP was independently associated with severity of coronary artery disease assessed by SYNTAX score (OR= 54.883, p ˂0.001). Conclusion:  hs-CRP was a significant independent predictor of coronary artery disease severity  assessed by SYNTAX score in patients presenting with AMI.