Cut-off Levels of High Sensitive C-Reactive Protein in Coronary Acute Syndrome

Acute coronary syndrome (ACS) is the gravity of cardiac inflammatory response characterized by activation of macrophages and T lymphocytes that release various cytokines. These cytokines will induce the formation of acute phase reactants, C-reactive protein (CRP) in the liver. Research on population indicates that high sensitive C-reactive protein (hs-CRP) level is an independent risk factor for coronary heart disease (CHD) in both men and women. The purpose of this study was to determine the cut-off levels of hs-CRP in acute state (ACS) with stable condition (CHD). A cross sectional observational study was conducted comparatively with consecutive sample selection to ACS or CHD patients. Levels of hs-CRP were analyzed by unpaired t test followed by sensitivity and specificity test. It was showed that average concentration of hsCRP in ACS group (mean 82.96 mg/L, SB 79.70, 95% CI 65.67-100.26) was significantly higher than the CHD group (mean 5.12 mg/L, SB 8.44, 95% CI 2.97-7.26). Levels of hs-CRP with cut-off point >8.23 mg/L have sensitivity of 88.10%, specificity 88.71%, with ROC 0.94. In conclusion, levels of hs-CRP with cut-off point >8.23 mg/L, could distinguish ACS and CHD with the highest sensitivity and specificity (sensitivity 88.10%, specificity 88.71%, ROC 0.94).Keywords: ACS, cut-off, hsCRP