Key result
High baseline hs-CRP predicts increased MACE and all-cause mortality in CAD patients undergoing PCI.
Why the study?
Inflammation in CAD has been linked to adverse outcomes, but the predictive value of baseline hs-CRP levels for adverse clinical events in CAD patients undergoing PCI needed assessment.
Does high baseline hs-CRP predict adverse clinical events in CAD patients undergoing PCI?
Meta-Analysis (n=60,544)
Does high baseline hs-CRP predict adverse clinical events in CAD patients undergoing PCI?
p-value: p=0.037
Baseline hs-CRP is a reliable predictor of adverse cardiovascular outcomes and mortality in CAD patients undergoing PCI, highlighting the prognostic value of inflammation.
hs-CRP may refine risk stratification after PCI; leaves open whether targeting it improves outcomes.
Inflammation in patients with coronary artery disease (CAD) has been linked to adverse clinical outcomes. A useful biomarker for measuring inflammation levels, high-sensitivity C-reactive protein (hs-CRP) in the blood can be used to detect the presence of low-grade inflammation. This study sought to assess the predictive value of baseline hs-CRP levels for adverse clinical events in CAD patients undergoing percutaneous coronary intervention (PCI). To investigate this topic, a meta-analysis was performed. We conducted a systematic search of PubMed, Embase, and the Cochrane Library for original articles reporting the correlation between hs-CRP levels and adverse clinical events in CAD patients undergoing PCI. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and conducted a meta-analysis by extracting relevant data. Our pooled calculations yielded hazard ratios or odds ratios with 95% confidence intervals. A total of 28 studies comprising 60544 patients were included in this analysis. High baseline hs-CRP levels predicted increased risk for major adverse cardiac events ( P = 0.037), major adverse cardiac and cerebrovascular events ( P = 0.020), all-cause mortality ( P = 0.001), cardiovascular mortality ( P < 0.001), death and/or myocardial infarction ( P = 0.017) in patients, as well as restenosis ( P < 0.001). However, there was no association between elevated baseline hs-CRP levels and thrombosis. In conclusion, in CAD patients undergoing PCI, baseline hs-CRP levels are reliable predictors of major adverse cardiac events, major adverse cardiac and cerebrovascular events, all-cause mortality, cardiovascular mortality, death and/or myocardial infarction, and restenosis. Therefore, hs-CRP can effectively assist in prognosis determination for CAD patients undergoing PCI.
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Yang et al. (2023) conducted a meta-analysis in Coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) (n=60,544). High baseline high-sensitivity C-reactive protein (hs-CRP) vs. Low baseline hs-CRP was evaluated on Major adverse cardiac events (p=0.037). High baseline hs-CRP levels predicted an increased risk for major adverse cardiac events (P=0.037) and all-cause mortality (P=0.001) in CAD patients undergoing PCI.
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