Relationship of C-Reactive Protein to Adverse Cardiovascular Events in Patients Treated by Percutaneous Coronary Intervention for Stable Angina Pectoris

Abstract

SUMMARYLow-grade inflammation as detected by increased C-reactive protein (CRP) levels predicts the risk of cardiovascular events. However, there is still controversy over the mid-term predictive value of CRP in patients referred for elective percutaneous coronary revascularization (PCI) for stable angina pectoris. The aim of this study was to assess the relationship between baseline CRP level and mid-term outcome of patients undergoing PCI.Two groups of patients with stable angina pectoris were prospectively studied. Group A consisted of 150 consecutive patients with a CRP level ≤ 3 mg/L, and group B consisted of 150 consecutive patients with a CRP level > 3 mg/L undergoing PCI at our institution.Comparing both groups of patients, the analysis confirmed a significant difference between medians of the CRP levels (0.5 versus 8 mg/mL; P < 0.001). A higher level of CRP in group B was associated with a lower presence of male gender (P < 0.05) and history of myocardial infarction (P < 0.05). On the other hand, in group B there was higher occurrence of smoking (P < 0.001), hypertension (P < 0.05), hypertriglyceridemia (P < 0.001), and diabetes mellitus (P < 0.01). The incidence of myocardial infarction based on postinterventional release of TnI > 1.5 ng/mL reached 12% in group A and 14% in group B (P = 0.73). Analyses were repeated with adjustment for significant baseline variables, which did not change our findings. The incidence of adverse cardiovascular events during a six month follow-up was 13% in both groups (NS).Increased CRP serum prior to PCI was not associated with the risk and extent of procedure-related myocardial injury measured by TnI release and does not portend heightened cardiovascular risk at six months after percutaneous revascularization. On the other hand, a CRP level > 3 mg/L was associated with a higher occurrence of cardiovascular risk factors (smoking, hypertension, hypertriglyceridemia, and diabetes mellitus). (Int Heart J 2005; 46: 195-204)

High Sensitivity C-Reactive Protein and Outcomes Following Percutaneous Coronary Intervention in Contemporary Practice

“…2,[36][37][38][39][40] However, these studies were conduced mostly in an era that used creatine kinase-MB as the predominant biomarker, predated contemporary cardiac troponin assays, or did not consider the 99th percentile cutoff for normal values. In the present study, we explored this issue by applying the universal definition of periprocedural MI (type 4a) using a contemporary cardiac troponin assay to detect myonecrosis.…”

Association of Pre-procedural High Sensitivity C-Reactive Protein with In-hospital Outcome of Patients Undergoing Percutaneous Coronary Intervention

“…16,20 In the present study, we explored this issue by applying the universal definition of periprocedural MI (type 4a) using a contemporary CK-MB assay to detect myonecrosis. 21 Patients with elevated baseline CK-MB levels were not included because it is a challenge to diagnose periprocedural MI in these patients.…”

Predictive Factors of TIMI-3 Flow Before Percutaneous Coronary Intervention in Facilitated Percutaneous Coronary Intervention for Acute Myocardial Infarction Analysis Based on the Fibrinolysis and Subsequent Transluminal Trial (FAST)

“…12,13) Nevertheless, this finding does not negate the adverse effect of smoking or the benefit of smoking cessation on the development and outcome of myocardial infarction [14][15][16] and ischemic heart disease. 17,18) It is particularly noteworthy that the rate of occurrence of coronary artery spasm is known to be higher in Japanese than in Westerners, 19) and there is no question about the need for smoking cessation from the standpoint of preventing myocardial infarction due to spasm. Limitations of the study: It is impossible to rule out the possibility that cases of spontaneous reperfusion were included among the patients who were enrolled.…”