The prognostic value of high-sensitive C-reactive protein and cardiac troponin T in young and middle-aged patients with chest pain without ECG changes

Background: There is growing evidence of the prognostic importance of inflammatory markers in angina pectoris. However, the independent value of high-sensitive C-reactive protein (hsCRP), cardiac troponin T (cTnT), or their combination has not been established in young patients with angina pectoris without ECG changes. Therefore, we assessed the 6-month prognostic values of serum hsCRP and cTnT in young and middle-aged patients who were admitted to the hospital with chest pain but without ECG changes. Methods: Forty young or middle-aged patients (45±10 years old; two females) were included in the study. All had chest pain for the first time without ST-T changes or any other ECG changes and with normal CPK-MB levels. Blood was drawn on admission, separated, and serum was frozen at -80°C for 1 year until thawed and studied as one batch in order to measure hsCRP and cTnT levels. A clinical follow-up was done for 6 months. Results: Our findings showed that the strongest independent marker of an adverse outcome was the hsCRP level on admission (sensitivity 66.7%; specificity 94.1%); cTnT level added a little to the specificity (97.1%), but did not add to the sensitivity that was found by hsCRP level. Conclusions: hsCRP level on admission could be an independent prognostic marker in young and middle-aged patients with angina pectoris without ECG changes and without CPK-MB elevation.