C-reactive protein (CRP) is an objective marker widely used for screening inflammatory levels in several diseases. Evidence suggests that inflammation plays a key role in the pathogenesis of atherosclerosis. The inflammatory process may promote plaque rupture causing acute coronary syndrome (ACS). Multiple studies have cleared that CRP is an independent risk predictor of cardiovascular events. Therefore, the inflammatory assessment is essential to improve the management of coronary artery disease patients.

The aim of this study is to assess the usefulness of CRP for the screening of anatomical complexity CAD regarding patients admitted for ACS.

It's a retrospective study conducted between September 2020 and February 2021 including all the patients admitted for NSTEMI and undergoing coronary angiography in the cardiology department of IBN ROCHD University hospital. ACC/AHA classification was used to determine the anatomical complexity of CAD.

In total, 74 patients were included. Mean age was 59years old, with male predominance (sex ratio=2.08). Among the patients, 44.6% had past medical history of hypertension, while 28.4% were diabetic. Among the patients, 38% were chronic smokers and 9% were weaned. Among the patients, 63% were admitted for high-risk NSTEMI. Mean troponin level was 10,566pg/L and mean CRP value was 45.2mg/L. Among the patients, 8.1% had normal coronary angiography, 33.8% had one vessel disease while 58.1% had multivessel disease. Elevated CRP level was significantly associated to the anatomical complexity of CAD (P=0.019). Mean value of CRP was 25mg/L in the simple CAD group versus 57.6mg/L in the complex CAD group with a significant difference between groups (P=0.028).

The severity of CAD was positively correlated with the level of CRP. Therefore, these findings suggest its value as a biomarker for predicting CAD. Serum CRP could be useful for risk stratification and may help for the management of CAD.