Serum Acute Phase Proteins As Novel Markers of Myocardial Injury in Acute Carbon Monoxide Poisoned Patients

Document Type : Original Article


1 Forensic Medicine and Clinical Toxicology, Department, Faculty of Medicine, Tanta University, Tanta, Egypt

2 Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta, Egypt,

3 Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt

4 Cardiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt


Acute carbon monoxide (CO) poisoning is considered one of the most common types of poisoning. CO stimulates inflammatory processes that may activate acute phase response. Additionally, myocardial injury is considered a serious complication of this type of poisoning. Hence, the aim of this study was to assess some acute phase proteins in acute CO poisoned patients and their possible role as novel markers of carbon monoxide induced myocardial injury. Fifty patients with acute carbon monoxide poisoning admitted to Poison Control Unit, Tanta University from the first of May 2013 to the end of April 2015 were studied. Each patient was subjected to full history taking, clinical examination and the following investigations; arterial blood gases, serum troponin I (TnI), acute phase proteins (high sensitive serum C- reactive protein (hs-CRP), total leucocytic count (TLC), serum albumin) and carboxyhemoglobin (COHb) concentration were measured. Apparently healthy fifty individuals matched for age and sex of the studied cases represented the control group. The mean age of the studied group was 34.7 ± 10.3y with nearly equal sex distribution (24 female: 26 male). Palpitation was the most common symptom (84%), hypotension and tachycardia were recorded in 76% and 70% respectively. ECG was normal in 30%, sinus tachycardia was observed in 60%, while ischemic changes were detected in 24% of the studied patients. In addition, serum CRP and TLC were higher while serum albumin was lower in the studied patients than in control subjects. Moreover, acute phase proteins were affected more significantly and correlated well with myocardial injury. So, the determination of CRP level, TLC or serum albumin on admission could be readily available and effective tools in evaluating acute CO poisoning and detecting the presence of myocardial injury.