Diagnostic value of CRP and Lp(a) in coronary heart disease

Acta Cardiol. 2002 Jun;57(3):197-204. doi: 10.2143/AC.57.3.2005389.

Abstract

Objectives: Increased lipoprotein (a) [Lp(a)] concentration was reported to be an independent risk factor for coronary heart disease (CHD). Recent epidemiological studies affirmed the value of C-reactive protein (CRP) as the strongest, univariate predictor of the cardiovascular events. We decided to establish cut-off levels providing maximum diagnostic efficiency for CHD.

Methods: In this study we measured CRP and Lp(a) concentrations in patients with angiographically demonstrated CHD (group A, n: 120), patients without any angiographically demonstrable lesion (group B, n: 62) and a group of healthy subjects (group C, n: 41). Data were evaluated correcting for lipid and lipoprotein concentrations, diabetes mellitus, hypertension, smoking, age, and body mass index in men and women. ROC curve based cut-off values (comparing group A versus groups B and C) and associated diagnostic performances of the assays were evaluated.

Results: Significant increases were noted in serum CRP concentrations in men and women, in groups A vs. B,A vs. C, B vs. C. Lp(a) concentrations were not different among groups in men but were higher in group A vs. B and C in women. Optimal cut-off levels for CRP in women and men were found as 2.1 and 3.0 mg/l with the diagnostic values of 0.792 and 0.770, respectively. For Lp(a) optimal cut-off levels were found as 22.6 and 9.8 mg/dl with the diagnostic values of 0.612 and 0.596 in women and men, respectively.

Conclusion: The CRP level is quite efficient for separation of patients from controls. Therefore keeping in mind the lack of specificity, the CRP level may be a useful tool in the diagnosis of coronary heart disease. However, the Lp(a) level is not efficient enough to support the use of Lp(a) measurement for management of coronary heart disease.

MeSH terms

  • C-Reactive Protein / analysis*
  • Case-Control Studies
  • Coronary Angiography
  • Coronary Disease / blood
  • Coronary Disease / diagnosis*
  • Female
  • Humans
  • Lipoprotein(a) / blood*
  • Male
  • Middle Aged
  • ROC Curve
  • Reference Values
  • Sensitivity and Specificity

Substances

  • Lipoprotein(a)
  • C-Reactive Protein