Preprocedural C-Reactive Protein Predicts Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-elevation Myocardial Infarction a systematic meta-analysis

Abstract

Risk assessment in patients with acute coronary syndromes (ACS) is critical in order to provide adequate treatment. We performed a systematic meta-analysis to assess the predictive role of serum C-reactive protein (CRP) in patients with ST-segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention (PPCI). We included 7 studies, out of 1,033 studies, with a total of 6,993 patients with STEMI undergoing PPCI, which were divided in the high or low CRP group, according to the validated cut-off values provided by the corresponding CRP assay. High CRP values were associated with increased in-hospital and follow-up all-cause mortality, in-hospital and follow-up major adverse cardiac events (MACE), and recurrent myocardial infarction (MI). The pre-procedural CRP predicted in-hospital target vessel revascularization (TVR), but was not associated with acute/subacute and follow-up in-stent restenosis (ISR), and follow-up TVR. Thus, pre-procedural serum CRP could be a valuable predictor of global cardiovascular risk, rather than a predictor of stent-related complications in patients with STEMI undergoing PPCI. This biomarker might have the potential to improve the management of these high-risk patients.

Red cell distribution width in coronary heart disease: prediction of restenosis and its relationship with inflammatory markers and lipids

“…Hence, the key factors influencing ISR are important for clinical treatment and prognosis. Recent studies have shown that laboratory serological parameters, such as the C-reactive protein (CRP) level,5 neutrophil to lymphocyte ratio6 and average blood platelet volume,7 can predict the occurrence of stent restenosis. There are multiple other factors, such as vascular damage caused by stent placement, local and systemic inflammatory responses induced by stent implantation and of coronary lesion severity, that may also affect stent restenosis.…”

Prognostic impact of baseline C‐reactive protein levels on mortality after transcatheter aortic valve implantation

“…Also, in the other CV interventions, high‐baseline CRP levels have been suggested to be associated with poor postinterventional outcomes. A meta‐analysis by Mincu et al 5 of seven studies enrolling a total of 6993 patients undergoing primary PCI for ST‐segment elevation myocardial infarction (MI) found that high‐baseline CRP levels predicted increased in‐hospital target vessel revascularization, in‐hospital/follow‐up mortality, in‐hospital/follow‐up major adverse cardiac events (MACE), and recurrent MI. Also, in a meta‐analysis by Li et al 8 of 15 studies including a total of 3110 patients undergoing CABG, high‐baseline CRP levels were associated with increased postoperative atrial fibrillation.…”

“…C‐reactive protein (CRP) levels play an important role in predicting prognoses of cardiovascular diseases (CVD) (stable coronary artery disease, 1 acute coronary syndrome, 2,3 and peripheral artery disease 4 ) and outcomes after cardiovascular (CV) interventions (percutaneous coronary intervention [PCI], 5‐7 coronary artery bypass grafting [CABG], 8 and vascular surgery 9 ). Several biomarkers (brain natriuretic peptides, troponins, galectin‐3, growth differentiation factor‐15, and microRNAs) have been known to predict outcomes after transcatheter aortic valve implantation (TAVI) 10 .…”

Heart failure from cancer therapy: can we prevent it?

“…The analysis was performed as previously described, [8][9][10] complying with the 'Cochrane Handbook for Systematic Reviews of Interventions', 11 and the 'Preferred Reporting of Items for Systematic Meta-Analysis (PRISMA)' reporting guidelines. The analysis was performed as previously described, [8][9][10] complying with the 'Cochrane Handbook for Systematic Reviews of Interventions', 11 and the 'Preferred Reporting of Items for Systematic Meta-Analysis (PRISMA)' reporting guidelines.…”