Elevated levels of C-reactive protein before coronary artery bypass grafting prediction recurrence of ischemic events

Recent studies have shown an involvement of the inflammatory system in the pathogenesis of ischemic heart disease, and markers of inflammation were found to be correlated with prognosis.(1-4) In unstable angina, elevated serum levels of C-reactive protein (CRP), an aspecific but sensitive marker of inflammation, were found to have a short-term prognostic value unrelated to myocardial cell damage, myocardial ischemia, or activation of the hemostatic system.(3,5,6) The long-term prognostic value of elevated CRP levels was reported in patients with stable or unstable coronary artery disease,(4,7,8) and in healthy subjects with high(9,10) and low levels(11) of coronary risk factors. Several randomized and observational studies have identified the variables relevant to patients' prognosis after coronary artery bypass grafting (CABG),(12-15) but none of these studies have identified a serologic marker of long-term outcome or have considered the role of the inflammatory system in patients with CABG. We studied 86 patients with stable or unstable ischemic heart disease who underwent CABG to ascertain whether an activation of the inflammatory system before surgery, detected by elevated serum levels of CRP, was associated with prognosis.