RELATION OF HIGH SENSITIVITY C-REACTIVE PROTEIN WITH ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH AND WITHOUT TYPE-2 DIABETES MELLITUS

BACKGROUND: Coronary artery disease (CAD) is a major contributor to cardiac morbidity and mortality. Type 2 diabetes mellitus (T2DM) accelerates atherosclerosis through chronic low-grade inflammation, increasing the risk of CAD and its sequelae. High-sensitivity CRP (Hs-CRP) serves as an independent marker of this inflammation, aiding in risk assessment. This biomarker's significance extends beyond clinical settings into forensic medicine, where it can offer insights into the inflammatory status of individuals prior to death, aiding in the determination of cause of death. METHODOLOGY: This cross-sectional study conducted from January 2021 to January 2022 employed non-probability consecutive sampling. Ninety acute myocardial infarction (MI) patients of both genders presenting in tertiary care hospitals of Peshawar were included in the study. They were categorized into two groups: Group 1 (T2DM with acute MI) and Group 2 (acute MI without T2DM). Hs-CRP levels were measured using the immunoturbidimetric method. Independent t-test compared mean age and BMI, Chi-square tested gender distribution, and Mann-Whitney U assessed Hs-CRP differences across the groups. RESULTS: Male subjects had a higher mean age than females. Group 1 patients were significantly older (59.18 ± 8.45 years) than Group 2 (54.82 ± 14.48 years). Median Hs-CRP levels were significantly higher in diabetic MI patients (Group 1: 2.20 mg/L, IQR 7.85) compared to non-diabetic MI patients (Group 2: 0.60 mg/L, IQR 1.35) (p=0.007). Among 90 MI patients, 38 developed complications, Hs-CRP levels were significantly higher in those with complications (p=0.01) and in diabetics with complications as compared to non-diabetics with complications (p=0.03). CONCLUSION: T2DM patients with MI exhibited elevated Hs-CRP, indicating greater inflammatory burden and higher complication risk. Hs-CRP may aid in risk stratification and includes forensic relevance in assessing pre-mortem inflammation as well. KEYWORDS: Coronary artery disease, Type 2 diabetes mellitus, Hs-CRP, atherosclerosis, chronic low-grade inflammation