Key result
A 9-month follow-up hsCRP level >3.0 mg/L was an independent predictor of major adverse cardiovascular events (HR 1.29) and was associated with a lower cardiovascular event-free survival rate compared to hsCRP <1.0 mg/L.
Why the study?
Does a high hsCRP level (>3.0 mg/L) at 9 months post-DES implantation predict long-term major adverse cardiovascular events and in-stent restenosis?
Cohort (n=1,763)
No
Does a high hsCRP level (>3.0 mg/L) at 9 months post-DES implantation predict long-term major adverse cardiovascular events and in-stent restenosis?
Hazard Ratio: 1.29 (95% CI 1.02–1.62)
Absolute Event Rate: 64.5% vs 71.6%
p-value: p=0.035
Elevated hsCRP levels (>3.0 mg/L) at 9 months post-DES implantation independently predict long-term major adverse cardiovascular events and higher rates of in-stent restenosis.
INTRODUCTION: The level of 9-month high-sensitivity C-reactive protein (hsCRP) in predicting cardiovascular outcomes is scanty in patients at 9 months after receiving drug-eluting stent (DES) implantations. This study aims to evaluate the relationship between 9-month follow-up hsCRP levels and long-term clinical outcomes in patients at 9 months after receiving DES. METHODS: A total of 1,763 patients who received 9-month follow-up angiography were enrolled and grouped according to hsCRP level 9 months after the DES implantation: group I (718 patients, hsCRP<1.0 mg/L), group II (639 patients, 1.0 ≦ hsCRP ≦ 3.0 mg/L), and group III (406 patients, hsCRP>3.0 mg/L). RESULTS: Group III patients had a lower cardiovascular event-free survival rate than group I or II patients during a follow-up of 64 ± 45 months (64.5% vs. 71.6% vs. 72.8%, respectively, p = 0.012). Multivariate analysis showed that a follow-up hsCRP level <3.0 mg/L was an independent predictor of a major adverse cardiovascular event (cardiac death, reinfarction, target lesion revascularization, stenting in a new lesion, or coronary bypass surgery). Group III patients had a higher restenosis rate (11.3% vs. 5.8% vs. 6.6%, respectively, p = 0.002) and loss index (0.21 ± 0.32 vs. 0.16 ± 0.24 vs. 0.18 ± 0.28, respectively, p = 0.001) than group I or II patients in 9-month follow-up angiography. CONCLUSIONS: A high 9-month follow-up hsCRP level is an independent predictor of long-term clinical cardiovascular outcomes in patients at 9 months after DES implantation. It is also associated with a higher restenosis rate, larger late loss and loss index at 9 months after DES implantation.
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Hsieh et al. (2015) conducted a cohort in Coronary artery disease 9 months after drug-eluting stent implantation (n=1,763). 9-month follow-up hsCRP level >3.0 mg/L vs. hsCRP level <1.0 mg/L was evaluated on Cardiovascular event-free survival (freedom from cardiac death, reinfarction, target lesion revascularization, stenting in a new lesion, or coronary bypass surgery) (HR 1.29, 95% CI 1.02-1.62, p=0.035). A 9-month follow-up hsCRP level >3.0 mg/L was an independent predictor of major adverse cardiovascular events (HR 1.29) and was associated with a lower cardiovascular event-free survival rate compared to hsCRP <1.0 mg/L.
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