Abstract Introduction There is limited evidence on the association between elevated pre-procedural C-reactive protein (CRP) levels and subsequent in-stent restenosis (ISR) or repeat revascularization after percutaneous coronary intervention (PCI). Purpose We performed a scoping review and meta-analysis, investigating the association between elevated baseline CRP and the incidence of ISR and repeat revascularisation after index PCI. Methods Relevant studies were identified following a US National Institutes of Health (PubMed) database search published until 01st-Feb-2025. Included studies had to be original research with: (i) angiographically determined ISR or repeat revascularization group (which included target lesion and target vessel revascularization, TLR/TVR), (ii) angiographically or clinically determined no-ISR or no-TLR/TVR group, and (iii) CRP levels measured before the index PCI procedure for both groups. Odds ratio (OR) and its 95% confidence interval (CI) between ISR and no-ISR, and TLR/TVR and no-TLR/TVR groups were ascertained for each included study. The pooled OR and its 95% CI was derived after pooling study level results using a random or fixed effects model, employing a Z test. Results Out of a total of 909 unique results, 157 full-text articles were assessed for eligibility, and 146 were excluded. In total, 11 articles were included for quantitative synthesis 11 for the ISR endpoint (2094 cases/3357 controls), and 10 for the TLR/TVR endpoint (2432 cases/3756 controls). A significant association was observed for the ISR endpoint (OR= 2.03 (95%CI= 1.42, 2.89) and the TLR/TVR endpoint (OR= 1.38, 95%CI= 1.19, 1.61) (Figure 1A. and 1B. respectively). No visual evidence of publication bias was detected using Begg’s funnel plots for both endpoints. (Figure 1A’. and 1B’. respectively). Conclusions Our results suggest that there is a significant association between elevated pre-PCI CRP and both subsequent ISR and repeat revascularization. Further validation of these results is warranted using a formal systematic review and meta-analysis.Main resultsFor image description, please refer to the figure legend and surrounding text.
Rai et al. (Sun,) studied this question.