C-reactive protein and alpha 1-acid glycoprotein in monitoring of patients with acute arterial occlusion.

C-reactive protein (CRP) and alpha 1-acid glycoprotein (AGP) levels were studied in sera of 75 patients with acute arterial occlusion. Depending on the degree of ischaemia, patients were divided into two groups: grade I--26 patients--and grade II--49 patients. All patients were treated surgically; 42 embolectomies, 17 endarterectomies and 16 bypasses were performed. After surgery in 19 patients various complications were observed. The concentration of both proteins at the time of admission was higher in the serum of patients with grade II than with grade I ischaemia. Similarly the concentration of both proteins was significantly higher in the sera of the patients admitted after 8 h than in patients admitted within 8 h of the onset of ischaemia. CRP and AGP levels were significantly higher in the serum of patients with ischaemia of the lower limb than in those with ischaemia of the upper limb. In all patients 2-3 days after surgery a significant increase in serum CRP and AGP was observed. In uncomplicated cases on days 7-10 the values of both proteins decreased below the level observed at the time of admission. However, in patients who experienced postoperative complications high levels of both serum proteins (especially CRP) were found on days 7-10. Complications were detected with a sensitivity and specificity of 84 and 95%, respectively, using a CRP level of 49 mg l-1 as the cut-off point.