High-sensitivity C-reactive protein may be an indicator of the development of atherosclerosis in myocardial bridging

Abstract: Background: Inflammation is one of the key mechanism in the development and progression of coronary artery disease. Myocardial bridging (MB) increases the tendency for development of atherosclerosis. The role of inflammation on the development of atherosclerosis in the MB is not clear. In this study, we investigated the existence of inflammation in the patients who have atherosclerotic plaque in the bridged segment. Methods: This study included 40 patients (group I) presented with stable angina pectoris and detected MB in LAD on coronary angiography and 30 control subjects (group II) with normal coronary angiogram. Patients in group I were divided into two subgroups based on the findings on intravascular ultrasound (IVUS): group IA included 25 patients without atherosclerotic lesion in any coronary artery and group IB included 15 patients with atherosclerotic lesion in addition to MB in bridged segment of LAD. High-sensitivity C-reactive protein (hs-CRP) levels were compared between group I and II and group IA and IB. Results: IVUS showed an atherosclerotic involvement with the proximal segment of MB in 15 patients (=group IB). No plaques were seen in other coronary arteries, in distal of MB or in the bridged segment. With regards to the level of hs-CRP, while no difference was established between group I and group II (1.7±0.4 mg/L vs 1.9±0.6 mg/L, p >0.05), hs-CRP was significantly higher in group IB than in group IA (3.2±0.3 mg/L vs 1.5±0.2 mg/L, p =0.001) and control group (3.2±0.3 mg/L vs 1.9±0.6 mg/L, p =0.03). A significant positive correlation was detected between the hs-CRP and the percentage of atherosclerotic stenosis on IVUS in group IB (R =0.639, p =0.01). Conclusions: These results indicate the presence of a low grade inflammation in patients with atherosclerotic lesion in bridged segment. [Copyright &y& Elsevier]