High-sensitivity C-Reactive protein predicts post-percutaneous coronary intervention cardiovascular risk with CKD status effect: evidence from a prospective registry study

Background High-sensitivity C-reactive protein (hsCRP) is a critical prognostic marker in patients undergoing percutaneous coronary intervention (PCI). However, the impact of chronic kidney disease (CKD) on this prognostic value remains unclear. Purpose This study evaluates the prevalence and prognostic significance of elevated hsCRP in PCI patients with and without CKD. Patients and methods 18,226 PCI patients from a large tertiary center between January 2017 and December 2018 were included. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2, and elevated hs-CRP was defined as >2 mg/L. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCEs), defined as the composite of all-cause mortality, myocardial infarction, stroke, and target vessel revascularization. Results Among the 18,226 patients, 1,762 (9.67%) had CKD. Elevated hsCRP was observed in 40.64% of CKD and 31.15% of non-CKD patients (p<0.001). MACCE rates were higher in patients with elevated hsCRP in both CKD (12.2% vs. 16.5%) and non-CKD groups (9.1% vs. 10.4%). After multivariate adjustment, elevated hsCRP was significantly associated with MACCEs in both CKD [HR=1.31, 95% CI (1.02–1.69), p=0.034] and non-CKD groups [HR=1.12, 95% CI (1.01–1.24), p=0.044]. No significant interaction was found between hsCRP and CKD status (p=0.196). Conclusion Elevated hsCRP is independently associated with increased MACCEs risk in PCI patients, regardless of CKD status.