Key result
An increase in hsCRP concentration >0.9 mg/l (>25%) at one month after coronary stenting was highly predictive of restenosis at 12 months (AUC 0.89; 95% CI 0.79-0.99; p=0.0005).
Why the study?
Inflammation plays a key role in atherogenesis, neointimal proliferation, and restenosis, prompting investigation into whether dynamic changes in hsCRP levels relate to restenosis following elective coronary stenting.
Does the dynamic change in high-sensitivity C-reactive protein (hsCRP) blood levels predict stent restenosis at 12 months in patients with stable exertional angina undergoing elective coronary stenting?
Cohort (n=91)
Does the dynamic change in high-sensitivity C-reactive protein (hsCRP) blood levels predict stent restenosis at 12 months in patients with stable exertional angina undergoing elective coronary stenting?
Effect estimate: AUC 0.89 (95% CI 0.79-0.99)
p-value: p=0.0005
An increase in hsCRP >0.9 mg/L at one month post-stenting is a strong predictor of angiographic stent restenosis at 12 months.
May support hsCRP monitoring to flag restenosis risk after elective stenting; hypothesis-generating and leaves open incremental value over standard predictors.
Aim To analyze the relationship between serum concentrations of high-sensitivity C-reactive protein (hsCRP) in dynamics and development of restenosis at 12 months following elective coronary stent placement (CSP).Material and methods The key role in atherogenesis, neointimal proliferation and restenosis belongs to inflammation. This study included 91 patients (median age, 60 [56; 66] years) with stable exertional angina after an elective CSP using second-generation stents. Follow-up coronarography was performed for 60 patients at 12 months. Concentration of hsCRP was measured immediately prior to CSP and at 1, 3, 6, and 12 months after CSP. Restenosis of the stented segment (50% or more narrowing of the stented segment or a 5-mm vessel segment proximally or distally adjacent to the stented segment) was observed in 8 patients.Results According to results of the ROC analysis, the increase in hsCRP concentration >0.9 mg/l (>25%) at one month after CSP had the highest predictive significance with respect of restenosis (area under the ROC curve, 0.89 at 95 % confidence interval (CI) from 0.79 to 0.99; sensitivity, 87.5 %; specificity, 82.8 %; р=0.0005), which was superior to the absolute value of hsCRP concentration >3.0 mg/l (area under the ROC curve, 0.82 at 95 % CI from 0.68 to 0.96; р=0.0007).Conclusion Increased concentration of hsCRP ≥0.9 mg /l (≥25 %) at a month after CSP was associated with restenosis of the coronary artery stented segment.
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Filatova et al. (2020) conducted a cohort in Stable exertional angina (n=91). High-sensitivity C-reactive protein (hsCRP) measurement was evaluated on Restenosis of the stented segment (AUC 0.89, 95% CI 0.79-0.99, p=0.0005). An increase in hsCRP concentration >0.9 mg/l (>25%) at one month after coronary stenting was highly predictive of restenosis at 12 months (AUC 0.89; 95% CI 0.79-0.99; p=0.0005).
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