Back to Journals » Journal of Inflammation Research » Volume 7

High-sensitivity C-reactive protein and exercise-induced changes in subjects suspected of coronary artery disease

Authors Mouridsen MR, Nielsen OW, Carlsen CM, Mattsson N, Ruwald M, Binici Z, Sajadieh A

Received 11 September 2013

Accepted for publication 15 October 2013

Published 22 March 2014 Volume 2014:7 Pages 45—55


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Mette Rauhe Mouridsen,1 Olav Wendelboe Nielsen,1 Christian Malchau Carlsen,1 Nick Mattsson,1 Martin H Ruwald,2 Zeynep Binici,3 Ahmad Sajadieh1

1Department of Cardiology, Copenhagen University Hospital of Bispebjerg, Copenhagen NV, Denmark; 2Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark; 3Department of Cardiology, Herlev Hospital, Herlev, Denmark

Background: Inflammation plays a major role in the development of atherosclerosis. We wanted to investigate the effects of exercise on high-sensitivity (hs) C-reactive protein (CRP) in subjects who were suspected of having coronary artery disease (CAD).
Methods: Blood samples were obtained before, 5 minutes after, and 20 hours after an exercise test in 155 subjects who were suspected of CAD. Coronary anatomy was evaluated by computed tomography coronary angiography and/or coronary angiography.
Results: Median baseline hs-CRP was higher in subjects with ≥50% coronary artery lumen diameter stenosis (n=41), compared with non-CAD-subjects (n=114), 2.93 mg/L (interquartile range 1.03–5.06 mg/L) and 1.30 mg/L (interquartile range 0.76–2.74 mg/L), respectively, P=0.007. In multivariate analyses testing conventional risk factors, hs-CRP proved borderline significant, odds ratio =2.32, P=0.065. Adding baseline hs-CRP to the results of the exercise test did not improve the diagnostic evaluation. Baseline natural logarithm (Ln) hs-CRP was positively associated with body mass index and baseline Ln-transformed hs troponin T levels, and negatively associated with the daily life activity level. An increase in hs-CRP of 0.13 mg/L (interquartile range 0.05–0.24 mg/L) from baseline to 5 minutes after peak exercise was found (P<0.0001), but the increase was not associated with presence of CAD. From baseline to 20 hours after exercise, no increase in hs-CRP was found.
Conclusion: In conclusion, hs-CRP was not independently associated with CAD. Hs-CRP increased immediately as a response to the exercise, and the increase was modest and not associated with CAD. The results indicate that exercise has potential to cause unwanted variations in hs-CRP and that exercise prior to hs-CRP measurements in subjects included in epidemiological studies, therefore, should be avoided.

Keywords: inflammation, stable angina pectoris, atherosclerosis, exercise testing

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]