Abstract

Unstable angina is frequently encountered by general practitioners and cardiovascular specialists. In the United States, of the 2.5 million patients admitted to hospital every year with suspected acute coronary syndromes, 1.5 million have unstable angina. The rest have myocardial infarction with or without ST elevation. Braunwald described unstable angina as a syndrome with five mutually non-exclusive causes; thrombosis, mechanical obstruction, dynamic obstruction (spasm of microvasculature and macrovasculature), inflammation or infection, and increased oxygen demand. The inflammatory etiology of atherosclerosis has prompted a search for biomarkers of inflammation that predict risk for coronary artery disease and its sequelae. Within the acute coronary syndromes (ACS) inflammatory biomarkers may provide independent information regarding pathophysiology, prognosis and optimal therapeutic strategies. CRP (C-reactive protein) an acute phase protein, an inflammatory biomarker produced by the hepatocytes in response to IL-6 accurately reflects ongoing inflammation than other inflammatory biomarkers because the plasma half-life of CRP is the same (about 19 h) under all conditions and the sole determinant of the plasma concentration is therefore the synthesis rate, which, in turn, reflects the intensity of the pathological process(es) stimulating CRP production

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