Alterations of serum high sensitive C reactive protein and lipid levels in newly diagnosed myocardial infarction subjects

R. R. Aparna, D. Raja Rajeswari, K. Ramalingam, R. Viswa Kumar, D. Balakrishna


Background: Acute Myocardial Infarction (AMI) is one of the major causes of mortality in the world. Atherosclerosis leading to AMI is the most common and severe clinical manifestation observed. Dyslipidemia is one of main traditional risk factor for MI, but in more than 50% of CHD events dyslipidemia was absent.  Atherosclerosis is considered as both a chronic inflammatory condition and a disorder of lipid metabolism. The present study was aimed to estimate the levels of serum lipids (total cholesterol, LDL cholesterol, HDL cholesterol) and hs-CRP an inflammatory marker in newly diagnosed AMI cases and to find out any correlation between these two.

Methods: The study was conducted on 50 newly diagnosed myocardial infarction cases, admitted in Cardiology Department Narayana Medical College, Nellore. Both the sexes were included. Fifty age and sex matched healthy individuals were selected as controls. Lipid levels are estimated by end point colorimetric assay (HUMANSTAR kit) and hs-CRP was estimated by immunofluorescence technique (Boditechkit).

Results: Significant raised levels of hs-CRP (p value <0.0001) and low HDL cholesterol (p value =0.0085) levels among the cases was noticed. A significant positive correlation was observed between LDL cholesterol and hsCRP (r=0.109, p=0.040). A non-significant positive correlation between hsCRP and HDL cholesterol  (r=0.291, p=0.453) was observed.

Conclusions: The results of the study implicate the role of inflammatory component in causing atherosclerosis or coronary artery disease rather than dyslipidaemias alone to be attributed for atherogenesis. Concomitantly HDL cholesterol levels were found to be low in cases that results from the inflammatory component in atherogenesis.


Cardiovascular disease, High density lipoproteins, High sensitive C reactive protein, Low density lipoproteins, Myocardial infarction

Full Text:



Prabhakaran D, Jeemon P, Roy A. Cardiovascular diseases in India: current epidemiology and future directions. Circulation. 2016 Apr 19;133(16):1605-20.

Enas E, Senthilkumar A. Coronary artery disease in Asian Indians: an update and review. Internet J Cardiol. 2001;1(2).

Verschuren WM, Jacobs DR, Bloemberg BP, Kromhout D, Menotti A, Aravanis C, et al. Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five year follow up of the seven countries study. JAMA. 1995 Jul 12;274(2):131-6.

Clearfield MB. C-reactive protein: a new risk assessment tool for cardiovascular disease. J Am Osteopathic Assoc. 2005 Sep;105(9):409-16.

Madjid M, Willerson JT. Inflammatory marker in coronary heart disease. Br Ed Bull. 2011;100:23-38.

Paoletti R, Gotto AM, Hajjar DP. Inflammation in atherosclerosis and implications for therapy. Circulation. 2004 Jun 15;109(1):III20-6.

Libby P. Ridker PM, Maseri A. Inflammation Atherosclerosis. Circulation. 2002;105(9):1135-43.

Willerson JT, Ridker PM. Inflammation as a cardiovascular risk factor. Circulation. 2004 Jun 1;109(1):2.

Van Leeuwen MA, Van Rijswijk MH. Acute phase proteins in the monitoring of inflammatory disorders. Baillière's Clini Rheumatol. 1994 Aug 1;8(3):531-52.

Ockene IS, Matthews CE, Rifai N, Ridker PM, Reed G, Stanek E. Variability and classification accuracy of serial high-sensitivity C-reactive protein measurements in healthy adults. Clini Chem. 2001 Mar 1;47(3):444-50.

Shrivastava AK, Singh HV, Raizada A, Singh SK. C-reactive protein, inflammation and coronary heart disease. Egyptian Heart J. 2015;67:89-97.

Calabro P, Golia E, TH Yeh E. Role of C-reactive protein in acute myocardial infarction and stroke: possible therapeutic approaches. Current Pharma Biotechnol. 2012 Jan 1;13(1):4-16.

Khan H, Alhomida AS, Sobki S. Lipid profile of patients with acute myocardial infarction and its correlation with systemic inflammation. Biomarker Insights. 2013; 8(8):1-7.

Ansell BJ, Watson KE, Fogelman AM, Navab M, Fonarow GC. High-density lipoprotein function: recent advances. J Am Coll Cardiol. 2005 Nov 15;46(10):1792-8.

Balci B. The modification of serum lipids after acute coronary syndrome and importance in clinical practice. Curr Cardiol Rev. 2011 Nov 1;7(4):272-6.

Detection EP. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486-97.

Catapano AL, Pirillo A, Norata GD. Vascular inflammation and low-density lipoproteins: is cholesterol the link? A lesson from the clinical trials. Br J Pharmacol. 2017 Nov;174(22):3973-85.