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European Heart Journal Advance Access published online on October 23, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp435
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

C-reactive protein improves risk prediction in patients with acute coronary syndrome, or does it?

Juan Carlos Kaski*

Division of Cardiac and Vascular Sciences, St George's University of London SW17 0RE, UK

* Corresponding author. Tel: +44 208 725 2628, Fax: +44 208 725 3328, Email: jkaski@sgul.ac.uk

This editorial refers to ‘C-reactive protein improves risk prediction in patients with acute coronary syndromes’, by F. Schiele et al. doi:10.1093/eurheartj/ehp273

The first 150 words of the full text of this article appear below.

Patients with acute coronary syndrome (ACS) represent a heterogeneous population. Both the severity of coronary artery disease and the extent of myocardial damage can differ markedly among patients presenting with ACS and these differences—in addition to age, left ventricular dysfunction, and the presence of co-morbidities—are likely to be responsible for different clinical outcomes in different patients. Accurate risk stratification of ACS patients continues to represent a major challenge to the managing physician.1,2 Established cardiovascular risk factors have been incorporated into algorithms for risk assessment in ACS patients and several clinical risk scores have been proposed in the past decade, which are promoted by International guidelines for management of patients with ACS.1,3 The Platelet glycoprotein IIb/IIIa in Unstable Angina: Receptor suppression Using Integrilin Therapy (PURSUIT),4 the Thrombolysis in Myocardial Infartion (TIMI),5 and the Global Registry of Acute Cardiac Events (GRACE)6 risk scores appear to be efficient prognostic indicators. However, they have . . . [Full Text of this Article]

Can the study results be extrapolated to other acute coronary syndrome populations?

What was the cause of such high C-reactive protein levels in these patients?

Incremental predictive value of GRACE risk score with the addition of C-reactive protein: would the assessment of other biomarkers have changed the study results?

Will these findings help improving effectiveness of treatment?

Conclusion


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Related articles in EHJ:

C-reactive protein improves risk prediction in patients with acute coronary syndromes
François Schiele, Nicolas Meneveau, Marie France Seronde, Romain Chopard, Vincent Descotes-Genon, Joanna Dutheil, Jean-Pierre Bassand, and on behalf on the ‘Reseau de Cardiologie de Franche Comte’
EHJ 2009 10.1093/eurheartj/ehp273. [Abstract] [Full Text]