BACKGROUND/AIMS: Although erythrocyte sedimentation rate (ESR) is included as a laboratory parameter in Truelove and Witts' classification, C-reactive protein (CRP) is also used for severity assessment in ulcerative colitis (UC). Frequently, the discordance between ESR and CRP is observed in clinical practice. The aim of this study was to determine which parameter is more related with clinical activity in UC patients. METHODS: A total of 155 patients with UC were identified from January 2004 to March 2005. Their medical records were reviewed within these patients, a total of 541 assessments of disease activity were made. Correlation of clinical activity and laboratory tests were evaluated by Pearson's correlation coefficient. RESULTS: Pearson's correlation coefficients of ESR and CRP with clinical symptoms were 0.376 and 0.258, respectively. The correlation coefficient between ESR and CRP was 0.403 (p=0.000). A total of 131 (24.2%) assessments revealed discordance between ESR and CRP. When discordance occurred, the correlation coefficients with clinical symptoms were 0.338 for ESR (p=0.000) and 0.034 for CRP (p>0.01). Dividing discordant patients into high ESR/low CRP group and low ESR/high CRP group, the coefficients were 0.420 for ESR and 0.226 for CRP in high ESR/low CRP group, and 0.333 for ESR and 0.068 for CRP in low ESR/high CRP group. CONCLUSIONS: The correlation analysis indicates that ESR appears to be a more reliable laboratory parameter of disease activity than CRP in assessing the severity of UC. In particular, when the level of ESR and CRP is discordant, ESR is more useful in assessing the disease activity in UC patients.
*Blood Sedimentation ; C-Reactive Protein/*analysis ; Colitis, Ulcerative/blood/*diagnosis ; Humans ; Severity of Illness Index

BACKGROUND AND OBJECTIVES: Systemic activation of the inflammatory system after aortic injury may play a role in the development of complications. The aim of this study was to determine the significance of the inflammatory markers for the mortality of patients suffering with medically treated type B acute aortic syndrome (AAS). SUBJECTS AND METHODS: We analyzed a total of 81 patients who were admitted with AAS within 24 hours from the onset of the symptoms and who were medically treated between January 2000 and December 2004. The patients were divided into two groups: the moribund patients who died within 2 weeks (group I: n=8, mean age: 64.0+/-11.0 years) and the patients who survived over 2 weeks (group II: n=73, mean age: 62.6+/-13.7 years). The serum high-sensitivity C-reactive protein (hsCRP) levels, the white blood cell (WBC) and monocyte counts, and the plasma D-dimer levels were measured on admission. RESULTS: The baseline clinical characteristics were not different between the two groups. The major causes of in-hospital death in group I were extensions or rupture of type B dissection (6 cases) and acute renal failure (2 cases). The multivariate analysis demonstrated that a high monocyte count (>1,250/mm3), and high levels of hsCRP (>11 mg/dL) and D-dimer (>1.2 mg/dL) were independent determinants of the short-term mortality (OR=6.39, 6.14 and 9.00; 95% CI=1.19 to 34.1, 1.14 to 32.9 and 1.20 to 67.4; p=0.02, 0.04 and 0.03, respectively). CONCLUSION: Systemic activation of the inflammatory system in type B AAS patients may be one of the important factors associated with the development of short-term mortality.
Acute Kidney Injury ; C-Reactive Protein ; Humans ; Inflammation ; Leukocytes ; Monocytes ; Mortality* ; Multivariate Analysis ; Plasma ; Prognosis ; Rupture

BACKGROUND/AIMS: The aims of this study were to identify the value of inflammatory markers as pretreatment prognostic factors for patients with multiple myeloma (MM) and to estimate the value of a prognostic index including these markers at diagnosis. METHODS: A total of 273 newly diagnosed MM patients undergoing active treatment were analyzed in this study. The prognostic values for survival of the pretreatment inflammatory markers were investigated. A myeloma prognostic index (MPI) was derived using prognostic factors determined to be independently significant on multivariate analysis. RESULTS: A high pretreatment neutrophil-lymphocyte ratio (NLR), low platelet count, and high C-reactive protein (CRP) level had independently unfavorable significance for overall survival (OS). The MPI was derived based on these factors. Per the MPI, 1 point each was assigned to high NLR, low platelet count, and high CRP. Risk categories were stratified into low- (score 0), intermediate- (score 1), and high-risk (score 2 or 3) groups. The MPI demonstrated independent statistical significance for OS on multivariate analysis ([intermediate: hazard ratio (HR), 1.91; 95% confidence interval (CI), 1.12 to 3.24] and [high: HR, 3.37; 95% CI, 2.00 to 5.69]; p < 0.001). Moreover, this significance could be observed regardless of age, renal function, and exposure to novel agents. In addition, the International Staging System risk group could be further significantly stratified using the MPI. CONCLUSIONS: The MPI, consisting of pretreatment inflammatory markers, NLR, platelet count, and CRP, might be effective in predicting the survival of newly diagnosed MM patients undergoing active treatment.
C-Reactive Protein ; Diagnosis* ; Humans ; Multiple Myeloma* ; Multivariate Analysis ; Platelet Count ; Prognosis

C-Reactive Protein ; analysis ; Female ; Humans ; Infant, Newborn ; Male ; Osteomyelitis ; diagnosis ; therapy

C-Reactive Protein ; analysis ; Humans ; Infant ; Intestinal Obstruction ; etiology ; Male ; Mucocutaneous Lymph Node Syndrome ; complications

OBJECTIVETo investigate the levels of high-sensitivity CRP (hsCRP) and insulin sensitivity index (ISI) in children with obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODSTwenty-nine children with OSAHS and 22 children with primary snoring (PS) were enrolled. Polysomnography was performed. Body mass index (BMI), hsCRP, serum lipids, fasting plasma glucose (FPG), and insulin (INS) were measured. ISI was calculated.

RESULTSThe apnea hypopnea index (AHI) in the OSAHS group was higher than that in the PS group (13.2 ± 9.2 vs 1.2 ± 1.1; P<0.05). The lowest oxygen saturation (LSaO2) in the OSAHS group was lower than that in the PS group [(78.5 ± 5.4)% vs (87.4 ± 3.7)%; P<0.05]. The values of hsCRP in the OSAHS group was higher than those in the PS group (2.8 ± 2.7 mg/L vs 0.6 ± 0.9 mg/L; P<0.05). There were no significant differences in the ISI and serum lipids between the two groups. The hsCRP level was negatively correlated with LSaO2 in the OSAHS group (r=-0.531, P<0.05).

CONCLUSIONSThe hsCRP level increases in children with OSAHS. The increased hsCRP level might be associated with an increased risk of cardiovascular diseases.

C-Reactive Protein ; analysis ; Child ; Child, Preschool ; Female ; Humans ; Insulin Resistance ; Male ; Sleep Apnea, Obstructive ; blood

BACKGROUND AND OBJECTIVES: The differences in plaque characteristics between non-culprit lesions (NCL) in acute coronary syndrome (ACS) patients (ACS-NCL) and target lesions (TL) in stable angina (SA) patients (SA-TL) are not well understood. We used a virtual histology-intravascular ultrasound (VH-IVUS) to compare the plaque components between ACS-NCL and SA-TL. SUBJECTS AND METHODS: We compared VH-IVUS findings between 290 ACS-NCL and 276 SA-TL. VH-IVUS classified the color-coded tissue into four major components: green (fibrotic); yellow-green (fibro-fatty); white {dense calcium (DC)}; and red {necrotic core (NC)}. Thin-cap fibroatheroma (TCFA) was defined as a NC > or =10% of the plaque area in at least 3 consecutive frames without overlying fibrous tissue in the presence of > or =40% plaque burden. RESULTS: Although the plaque burden was significantly smaller (52+/-13% vs. 54+/-14%, p=0.044), ACS-NCL had a greater %NC area (17.9+/-11.6% vs. 14.3+/-8.7%, p<0.001) and %DC area (9.7+/-9.8% vs. 8.1+/-8.0%, p=0.032) compared with SA-TL at the minimum lumen site. By volumetric analysis, ACS-NCL had a greater %NC volume (15.8+/-9.2% vs. 13.9+/-7.4%, p=0.006) compared with SA-TL. TCFA was observed more frequently in ACS-NCL compared with SA-TL (27.6% vs. 18.1%, p=0.032). Independent predictors of TCFA by multivariate analysis were ACS {odds ratio (OR): 2.204, 95% CI: 1.321-3.434, p=0.021} and high-sensitivity C-reactive protein (OR: 1.101; 95% CI 1.058-1.204, p=0.035). CONCLUSION: Although the plaque burden was significantly smaller, ACL-NCL had more vulnerable plaque components compared with SA-TL, and ACS and high-sensitivity C-reactive protein were the independent predictors of TCFA.
Acute Coronary Syndrome ; Angina, Stable ; C-Reactive Protein ; Calcium ; Humans ; Multivariate Analysis ; Plaque, Atherosclerotic ; Ultrasonography, Interventional

Adult ; Behcet Syndrome ; complications ; diagnosis ; Blood Sedimentation ; C-Reactive Protein ; analysis ; Cardiovascular Diseases ; etiology ; Humans ; Male

BACKGROUND: There are conflicting data in the literature regarding aspirin resistance. This study evaluated the effect of biochemical aspirin resistance on initial stroke severity in acute stroke patients who had taken aspirin. METHODS: We reviewed acute ischemic stroke patients who were already on aspirin. Biochemical aspirin resistance was defined as an aspirin reaction unit score of > or =550, as evidenced by the VerifyNow-Aspirin assay, which was performed after 4 days of continuous aspirin medication. Initial stroke severity was evaluated using National Institutes of Health Stroke Scale (NIHSS) scores at day 4, which were dichotomized into mild (0-7) and severe (> or =8). Modified Rankin Scale scores were determined at 3 months. The Alberta Stroke Program Early CT Scores (ASPECTS) were assessed on initial diffusion-weighted imaging (DWI). We examined the relationships between biochemical aspirin resistance and initial stroke severity. RESULTS: Nine of 106 patients (8.5%) had biochemical aspirin resistance. The initial stroke severity was significantly associated with DWI-ASPECTS (p<0.001), initial C-reactive protein level (p=0.005), biochemical aspirin resistance (p=0.009), and stenosis or occlusion of the relevant artery (p=0.029). Multivariate analysis showed that biochemical aspirin resistance [odds ratio (OR), 15.24; 95% confidence interval (CI), 2.49-93.31; p=0.003] and initial C-reactive protein level (per 1 mg/dL; OR, 2.43; 95% CI, 1.47-4.00; p=0.001) were independently associated with initial stroke severity (NIHSS score > or =8). However, biochemical aspirin resistance was not associated with clinical outcome at 3 months (p=0.366). CONCLUSIONS: Biochemical aspirin resistance was independently associated with initial stroke severity. This suggests that detection of biochemical aspirin resistance in acute ischemic stroke is useful when choosing the optimal treatment.
Alberta ; Arteries ; Aspirin ; C-Reactive Protein ; Constriction, Pathologic ; Humans ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Stroke

We developed a high-sensitivity C-reactive protein quantifiable chemiluminescent immunoassay (hs-CRP CLIA). The high-purity native CRP was purified from hepatic cirrhosis patient ascetic fluid by affinity and ion exchange chromatography and used as an immunogen to develop the monoclonal antibodies (mAbs) against CRP. Twenty-two mAbs were identified reactive with CRP in ELISA and 13 of them were reactive in the phosphorycholine ligand capture ELISA. The mAbs 10C5 and 10C11 were selected to develop the hs-CRP CLIA. The linearity and performance of the hs-CRP CLIA was characterized. It was showed not reactive when testing against other serum materials (IgG, hemoglobin and triglyceride). The reliable correlation (R2 > 0.993) was obtained between testing value (RLU/S) and the concentration of human serum CRP calibrator. The linearity fell in the range of 0.04-20.38 mg/L. The assay has good accuracy and reproducibility, the mean recovery was 99% and the precision of the intra- and inter assay was CVs (4.2%-5.8%) and (9.0%-11.5%), respectively. In testing of 90 human sera, this assay performed well and correlated comparably with a commercial hs-CRP ELISA kit. Thus, hs-CRP CLIA is an accurate, reliable, quantifiable assay for detection of high-sensitive C-reactive protein in serum, it may be useful to improve the risk assessment of cardiovascular disease and the prognosis of inflammatory bowel disease.
C-Reactive Protein ; analysis ; chemistry ; Humans ; Immunoassay ; methods ; Luminescent Measurements ; methods ; Sensitivity and Specificity