Elevated high-sensitivity C-reactive protein after percutaneous coronary intervention in patients with stable coronary artery disease: A proof-of-concept study

Objectives: Elevated levels of high-sensitivity C-reactive protein (hs-CRP) is associated with increased incidence of cardiovascular events. We aimed to investigate whether iatrogenic disruption of plaques by percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) would result in a meaningful rise in hs-CRP that could impact the short-term outcome. Methods and Results: From September 2017 to May 2018, we measured hs-CRP in 60 patients divided into three groups: Group I (20 patients with stable CAD undergoing elective PCI), Group II (20 patients with non-ST elevation-acute coronary syndromes undergoing PCI), and Group III (20 patients with stable and unstable CAD undergoing angiography without PCI). Samples for hs-CRP testing were withdrawn before the procedure, 6 and 24 h later. In Group I, levels increased from 2.4 ± 0.6 at baseline to 8.2 ± 1.7 mg/L 24 h later, P < 0.001. In Group II, levels increased from 7.7 ± 2.9 at baseline to 12.2 ± 3.5 mg/L 24 h later, P < 0.001. Group III showed no significant change. The median percentage change in Group I was significantly higher than both Groups II and III (239.09% [117.86–566.67] vs. 70.47% [−19.09–212.24] and 10.98% [−27.59–272.73], P < 0.001). No significant differences in baseline or 24-h hs-CRP levels were found between those who developed 30-day endpoints and those who did not. Conclusion: Iatrogenic disruption of plaques by PCI in stable CAD resulted in a significant rise of hs-CRP. However, this does not impact the short-term outcome.