Key result
Elevated baseline high-sensitivity C-reactive protein was significantly associated with an increased risk of cancer mortality (HR 1.74) in patients with stable coronary artery disease.
Why the study?
Although hs-CRP is a known risk factor for cardiovascular disease and cancer, its long-term impact on cancer mortality in patients with stable CAD remained to be investigated.
Does higher baseline hs-CRP predict cancer mortality in patients undergoing PCI for stable CAD?
Cohort (n=2,867)
No
Does higher baseline hs-CRP predict cancer mortality in patients undergoing PCI for stable CAD?
Hazard Ratio: 1.74 (95% CI 1.18–2.61)
Absolute Event Rate: 5.3% vs 2.8%
p-value: p=0.005
Elevated baseline hs-CRP is a significant independent predictor of long-term cancer mortality in patients with stable CAD undergoing PCI.
May aid cancer risk stratification in stable CAD post-PCI; hypothesis-generating and requires prospective validation.
BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) is a well known risk factor for the development of cardiovascular disease and cancer. We investigated the long-term impact of hs-CRP on cancer mortality in patients with stable coronary artery disease (CAD). METHODS AND RESULTS: This study was a retrospective analysis of 2,867 consecutive patients who underwent percutaneous coronary intervention for stable CAD from 2000 to 2016. The patients were divided into 2 groups according to median hs-CRP. We then evaluated the association between baseline hs-CRP and both all-cause and cancer deaths. Median hs-CRP was 0.10 mg/dL (IQR, 0.04-0.27 mg/dL). The median follow-up period was 5.8 years (IQR, 2.3-10.0 years). There were 416 deaths (14.5%), including 149 cardiovascular deaths (5.2%) and 115 (4.0%) cancer deaths. On Kaplan-Meier analysis the higher hs-CRP group had a significantly higher incidence of both all-cause and cancer death (log-rank, P<0.001 and P=0.001, respectively). On multivariable analysis higher hs-CRP was significantly associated with higher risk of cancer death (HR, 1.74; 95% CI: 1.18-2.61, P=0.005). CONCLUSIONS: Elevated baseline hs-CRP was significantly associated with cancer mortality in patients with stable CAD. Hs-CRP measurement may be useful for the identification of subjects with an increased risk of cancer death.
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Endo et al. (2018) conducted a cohort in Stable coronary artery disease (n=2,867). Elevated baseline high-sensitivity C-reactive protein (≥0.10 mg/dL) vs. Lower baseline hs-CRP (<0.10 mg/dL) was evaluated on Cancer death (HR 1.74, 95% CI 1.18-2.61, p=0.005). Elevated baseline high-sensitivity C-reactive protein was significantly associated with an increased risk of cancer mortality (HR 1.74) in patients with stable coronary artery disease.
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