Persistent high residual inflammatory risk (hs-CRP > 0.9 mg/L) significantly predicted MACE (HR 2.22; 95% CI 1.37-3.67; p=0.001) in Japanese patients with stable CAD undergoing PCI.
Cohort (n=2,032)
Does high residual inflammatory risk (hs-CRP > 0.9 mg/L) predict worse long-term clinical outcomes in Japanese patients with stable CAD after PCI?
Persistent or increased residual inflammation, indicated by serial hs-CRP > 0.9 mg/L, is a strong predictor of MACE and all-cause mortality in Japanese patients with stable CAD after PCI.
Effect estimate: HR 2.22 (95% CI 1.37-3.67)
p-value: p=0.001
The aim of this study was to investigate the long-term clinical impact of residual inflammatory risk (RIR) by evaluating serial high-sensitivity C-reactive protein (hs-CRP) in Asian patients with coronary artery disease (CAD). We evaluated 2032 patients with stable CAD undergoing percutaneous coronary intervention (PCI) with serial hs-CRP measurements (2 measurements, 6–9 months apart) from the period 2000 to 2016. A high-RIR was defined as hs-CRP > 0.9 mg/L according to the median value. Patients were assigned to four groups: persistent-high-RIR, increased-RIR, attenuated-RIR, or persistent-low-RIR. Major adverse cardiac events (MACE) and all-cause death were evaluated. MACE rates in patients with persistent high, increased and attenuated RIR were significantly higher than in patients with persistent low RIR (p < 0.001). Moreover, the rate of all-cause death was significantly higher among patients with persistent high and increased RIR than among patients with attenuated and persistent low RIR (p < 0.001). After adjustment, the presence of persistent high RIR (hazard ratio (HR) 2.22; 95% confidence interval (CI) 1.37–3.67, p = 0.001), increased RIR (HR 2.25, 95%CI 1.09–4.37, p = 0.029), and attenuated RIR (HR 1.94, 95%CI 1.14–3.32, p = 0.015) were predictive for MACE. In addition, presence of persistent high RIR (HR 2.07, 95%CI 1.41–3.08, p < 0.001) and increased RIR (HR 1.94, 95%CI 1.07–3.36, p = 0.029) were predictive for all-cause death. A high RIR was significantly associated with MACE and all-cause death among Japanese CAD patients. An evaluation of changes in inflammation may carry important prognostic information and may guide the therapeutic approach.
Takahashi et al. (Mon,) conducted a cohort in Stable coronary artery disease (n=2,032). Persistent high residual inflammatory risk (hs-CRP > 0.9 mg/L) vs. Persistent low residual inflammatory risk was evaluated on Major adverse cardiac events (MACE) (HR 2.22, 95% CI 1.37-3.67, p=0.001). Persistent high residual inflammatory risk (hs-CRP > 0.9 mg/L) significantly predicted MACE (HR 2.22; 95% CI 1.37-3.67; p=0.001) in Japanese patients with stable CAD undergoing PCI.