C-reactive protein and alpha-1-acid glycoprotein in monitoring of patients with chronic arterial occlusion of the lower limbs.

C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) levels were studied in the sera of 107 patients with chronic arterial ischaemia of the lower limbs. Depending on the degree of ischaemia, patients were divided into four groups: (i) intermittent claudication--20 patients; (ii) rest pain and ankle pressure above 50 mmHg--12 patients; (iii) rest pain and ankle pressure below 50 mmHg--25 patients; (iv) peripheral necrosis--50 patients. Reconstructive surgery was performed in 84 patients and primary major amputation in 23 cases. Levels of CRP and AGP increased with the severity of ischaemia. In uncomplicated cases, CRP and AGP concentrations decreased to normal values 7-10 days after surgery. In a group of 23 patients with postoperative necrotic complications, significant increases in CRP and AGP levels were found 7-10 days after surgery. These proteins, especially CRP, may be clinically useful in monitoring patients during the postoperative period with a CRP level greater than 50 mg/l predictive of complications with a sensitivity of 83% and a specificity of 94%.