Correlation of CRP Level with Intermediate and High Syntax Score in Patients with Acute Coronary Syndrome

In patients with acute coronary syndromes, inflammation has a major role in plaque rupture, which results in acute coronary artery obstruction. This vascular process is not limited only to the site of plaque destabilisation but also in the systemic level. So, it may be detected by determining plasma inflammatory markers. C-reactive protein (CRP) has been frequently studied in recent years and considered to be one of the most important markers. The SYNTAX score (SXscore) is a useful angiographic scoring system that has been developed to assess and quantify the extent, severity and complexity of coronary artery disease. In our study, we investigated whether baseline high-sensitivity CRP levels are associated with burden of coronary atherosclerosis assessed by SYNTAX score (SXScore). We enrolled 128 patients with ACS who underwent coronary angiography between January 2022 and November 2022. The patients were divided according to the SXScore: low SXScore (≤ 22), and intermediate-high SXScore (≥ 23). A total of 128 patients met the inclusion criteria and was included in the study. Among those 128 patients, 98 (76%) were males and 30 (23%) were females. The mean age of patients in the intermediate-high SXScore (61 ± 12 years) group was significantly higher than the low SXScore group (57 ± 10 years) with a P-value: 0.003. Coronary risk factor frequencies such as hypertension were present in 45%, type 2 diabetes mellitus in 42% and dyslipidemia in 83% of patients with no significant difference between both groups except for diabetes with a significant P-value: 0.008. Subjects with an intermediate-high SXScore had higher values of serum glucose, creatinine, peak troponin, and uric acid levels compared to the low SXScore subjects. In addition, the intermediate-high SXScore group showed significantly higher values of high sensibility CRP than the lower SXScore (17.8 ± 6.4 mg/L versus 10.2 ± 5.3 mg/L, P < 0.001). One of the most important results in this study was that serum hs-CRP levels on admission in patients with ACS could predict the severity and complexity of coronary atherosclerosis together with multivessel disease.