The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Elevated hs-CRP in Patients with Stable Angina Pectoris

안정형 협심증 환자에서 C-반응성 단백질 농도의 증가

  • Choi, Eun-Jin (Department of Preventive Medicine, Chonnam National University Medical School) ;
  • Shin, Min-Ho (Department of Preventive Medicine, Chonnam National University Medical School) ;
  • Kang, Won-Yu (Cardiovascular Center, Gwangju Veterans Hospital) ;
  • Hwang, Sun-Ho (Cardiovascular Center, Gwangju Veterans Hospital) ;
  • Kim, Wan (Cardiovascular Center, Gwangju Veterans Hospital) ;
  • Bak, Seung-Wook (Department of Internal Medicine, Yeosu Chonnam Hospital)
  • 최은진 (전남대학교 의과대학 예방의학교실) ;
  • 신민호 (전남대학교 의과대학 예방의학교실) ;
  • 강원유 (광주보훈병원 심혈관센터) ;
  • 황선호 (광주보훈병원 심혈관센터) ;
  • 김완 (광주보훈병원 심혈관센터) ;
  • 박승욱 (여수전남병원 내과)
  • Published : 2012.01.01
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Abstract

Background/Aims: The association between inflammatory markers and the severity of coronary artery disease (CAD) in patients with stable angina pectoris remains controversial. This study explored the relationships between the serum high-sensitivity CRP (hs-CRP) level and severity of coronary atherosclerosis in patients with stable angina. Methods: The study enrolled 377 stable angina patients (298 males, 79 females) undergoing coronary angiography from June 2006 to August 2010. Based on the coronary angiography results, they were divided into two groups according to the diameter of stenosis (DS): Group I ($DS\;{\geq}\;50%$) and Group II (DS < 50%). Multivariate logistic regression was used to examine the relationship between the hs-CRP level (high hs-CRP ${\geq}\;3.0\;mg/L$ versus low hs-CRP < 3.0 mg/L) and the severity of coronary stenosis. Results: Group I had higher hs-CRP levels than Group II [median hs-CRP (interquartile range); 0.70 (0.3-1.66) versus 1.11 (0.52-3.41) mg/L, p < 0.001]. After adjusting for major cardiovascular risk factors, a high hs-CRP level was significantly related to the severity of coronary atherosclerosis (OR 1.95, 95% CI = 1.16-3.30). Conclusions: Our data show that patients with ${\geq}\;50% $coronary stenosis have higher hs-CRP levels than patients with < 50% coronary stenosis and stable angina. Further study is needed to define the role of hs-CRP in the progression of angina pectoris.

목적: 본 연구는 안정형 협심증 환자 중 관상동맥 조영술을 실시하였던 환자들을 대상으로 고감도 C-반응성 단백질 (high sensitivity C-reactive protein, hs-CRP) 농도와 관상동맥질환의 정도와의 관계를 구명하고자 하였다. 방법: 2006년 6월부터 2010년 8월까지 광주소재 종합병원 심혈관 센터에 내원한 안정형 협심증 환자에서 관상동맥 조영술을 시행한 환자 377명(남자 298명, 여자 79명)을 대상으로 하였다. 자료는 2010년 5월부터 8월까지 수집하였다. 심혈관계 질환의 위험인자들은 의무 기록 조사를 통해 수집하였고, 관상동맥 경화의 정도는 관상동맥 협착이 50% 이상인군과 이하인 군으로 나누어 분석하였다. 결과: 관상동맥 협착이 50% 이상인 군은 전체대상자 377명중 172명으로 45.6%였다. 혈중 hs-CRP가 3.0 mg/L 이상으로 높은 군에서 낮은 군에 비해 관상동맥 협착에 대한 교차비가 2.28 (95% CI = 1.38-3.75)로 높았으며 성별, 나이, 고혈압, 당뇨병, 고밀도 지단백 콜레스테롤을 보정한 이후에 교차비가 1.95 (95% CI = 1.16-3.30)으로 여전히 유의한 관련성을 보였다. 결론: 안정형 협심증 환자에서 높은 혈중 hs-CRP 농도는 50% 이상의 관상동맥 협착과 유의한 관련성을 보였다. 그러나 이러한 관련성을 설명하기 위해서는 좀 더 자세히 평가된 관상동맥 경화의 심각도와 혈중 hs-CRP 농도의 상관관계에 대한 전향적인 연구가 더 이루어져야 할 것이다.

Keywords

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