C-REACTIVE PROTEIN, LEUKOCYTE COUNT AND MYELOPEROXIDASE AS PREDICTORS OF ADVERSE CARDIAC EVENTS IN ACUTE CORONARY SYNDROME PATIENTS

Abstract

Objective: The aim of the present study was to evaluate the role of C-reactive
protein (CRP), leukocyte count and myeloperoxidase (MPO) in predicting
adverse outcomes in acute coronary syndrome patients.
Methodology: Ninety consecutive patients with acute coronary syndrome (ACS)
were enrolled from Coronary Care Unit of Shaikh Zayed Hospital, Lahore from
January 2012 to April 2013. Baseline leukocyte count was determined by Abacus
cell counter while CRP and MPO levels were determined by using commercially
available enzyme immunoassays. Mortality and adverse cardiac events were
recorded for a follow up period of 6 months.
Results: Out of ninety patients 65 (72.2%) were males. Mean age of patients was
56.25±13.01 years (male patients 55.43±14.02 while female patients
58.4±9.88). Number of adverse events was highest (18.6%) in CRP > median
category, followed by leukocyte count > median (17.9%) and MPO > median
category (17.1%), respectively. Adverse event rate was found to be significantly
higher (p = 0.043) in CRP > median category as compared to CRP < median
category. Adverse event rate was also higher (p = 0.08) (clinically significant) in
> median category of leukocyte count but in case of MPO level it did not reach
level of statistical or clinical significance (p = 0.12).
Conclusion: CRP is a predictor of adverse outcome in acute coronary syndrome
patients and may serve as a marker in prognosis of ACS. Further studies with
large sample size are required for confirmation of predictive role of leukocyte
count.