Which test becomes abnormal in the earliest stage of coronary syndrome?

In cases of acute coronary syndrome (ACS), high sensitivity C-reactive protein (hs-CRP) can indeed become abnormal at an early stage. It is a marker of systemic inflammation and has been shown to have predictive value for cardiovascular events. Elevated levels of hs-CRP denote inflammation that may correlate with atherosclerotic plaque instability, which is a contributing factor to coronary syndrome.

While other biomarkers such as troponins, myoglobin, and CK-MB are specific to myocardial injury and can also indicate the presence of coronary syndrome, they typically reflect more direct damage to cardiac muscle and usually become elevated after symptoms or events like myocardial infarction. hs-CRP, on the other hand, can indicate an inflammatory response even before such damage occurs, making it a useful tool for assessing the risk and early changes associated with coronary syndrome.

Thus, in the context of early detection of coronary syndrome, hs-CRP is significant for reflecting underlying inflammatory processes, often preceding other markers that indicate direct myocardial injury or damage.