Key result
Elevated baseline C-reactive protein (> 3 mg/L) prior to elective percutaneous coronary intervention for stable angina was not associated with an increased risk of procedure-related myocardial infarction compared to normal CRP levels.
Why the study?
Does an elevated baseline CRP level (> 3 mg/L) predict increased risk of periprocedural myocardial infarction or 6-month adverse cardiovascular events in patients undergoing elective PCI for stable angina pectoris?
Cohort (n=300)
No
Does an elevated baseline CRP level (> 3 mg/L) predict increased risk of periprocedural myocardial infarction or 6-month adverse cardiovascular events in patients undergoing elective PCI for stable angina pectoris?
Absolute Event Rate: 14% vs 12%
p-value: p=0.73
Unlike in acute coronary syndromes, an elevated baseline CRP level (> 3 mg/L) does not predict periprocedural myocardial injury or 6-month adverse cardiovascular events in patients undergoing elective PCI for stable angina pectoris.
Elevated CRP should not guide periprocedural risk stratification in elective stable angina PCI; leaves open inflammation's role and need for prospective trials.
Low-grade inflammation as detected by increased C-reactive protein (CRP) levels predicts the risk of cardiovascular events. However, there is still controversy over the mid-term predictive value of CRP in patients referred for elective percutaneous coronary revascularization (PCI) for stable angina pectoris. The aim of this study was to assess the relationship between baseline CRP level and mid-term outcome of patients undergoing PCI. Two groups of patients with stable angina pectoris were prospectively studied. Group A consisted of 150 consecutive patients with a CRP level < or = 3 mg/L, and group B consisted of 150 consecutive patients with a CRP level > 3 mg/L undergoing PCI at our institution. Comparing both groups of patients, the analysis confirmed a significant difference between medians of the CRP levels (0.5 versus 8 mg/mL; P < 0.001). A higher level of CRP in group B was associated with a lower presence of male gender (P < 0.05) and history of myocardial infarction (P < 0.05). On the other hand, in group B there was higher occurrence of smoking (P < 0.001), hypertension (P < 0.05), hypertriglyceridemia (P < 0.001), and diabetes mellitus (P < 0.01). The incidence of myocardial infarction based on post-interventional release of TnI > 1.5 ng/mL reached 12% in group A and 14% in group B (P = 0.73). Analyses were repeated with adjustment for significant baseline variables, which did not change our findings. The incidence of adverse cardiovascular events during a six month follow-up was 13% in both groups (NS). Increased CRP serum prior to PCI was not associated with the risk and extent of procedure-related myocardial injury measured by TnI release and does not portend heightened cardiovascular risk at six months after percutaneous revascularization. On the other hand, a CRP level > 3 mg/L was associated with a higher occurrence of cardiovascular risk factors (smoking, hypertension, hypertriglyceridemia, and diabetes mellitus).
No takes yet. Share an insight, caveat, or question.
Veselka et al. (2005) conducted a cohort in Stable angina pectoris (n=300). Elevated baseline C-reactive protein (> 3 mg/L) vs. Normal baseline C-reactive protein (≤ 3 mg/L) was evaluated on Incidence of myocardial infarction based on postinterventional release of troponin I > 1.5 ng/mL at 24 hours (95% CI 0.61-2.34, p=0.73). Elevated baseline C-reactive protein (> 3 mg/L) prior to elective percutaneous coronary intervention for stable angina was not associated with an increased risk of procedure-related myocardial infarction compared to normal CRP levels.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: