C-reactive protein and cardiac troponin for early risk stratification in patients with acute coronary syndromes

An increasing body of evidence demonstrates that the acute coronary syndromes share a common pathophysiological background. New biochemical markers, and in particular cardiac troponins, are now available for risk stratification also in patients with minor myocardial damage. There is a linear relationship between the serum level of troponins and the risk of major cardiac events. However, in patients with normal cardiac troponins, the measurement of C-Reactive Protein (CRP) may add further information: in fact, an increased CRP is associated with an adverse outcome independent of an increased troponin. The time course of CRP and cardiac troponin elevation after the onset of myocardial damage may be one of the reasons of the independent prognostic value of the two markers. (C) 2001 Elsevier Science B.V. All rights reserved.