Key result
Elevated baseline hs-CRP levels were associated with a significantly lower incidence of major cardiovascular and cerebrovascular adverse events (HR 0.795) following percutaneous coronary intervention in non-diabetic patients with acute coronary syndrome.
Why the study?
Few data are available on the association between high-sensitivity CRP and long-term prognosis in non-diabetic ACS populations.
Does elevated baseline hs-CRP predict a lower incidence of MACCEs in non-diabetic ACS patients following PCI?
Cohort (n=419)
Non-blind
No
Does elevated baseline hs-CRP predict a lower incidence of MACCEs in non-diabetic ACS patients following PCI?
Hazard Ratio: 0.795 (95% CI 0.637–0.992)
Absolute Event Rate: 5.6% vs 12.4%
p-value: p=0.043
Elevated baseline hs-CRP levels may paradoxically predict a lower incidence of long-term MACCEs in non-diabetic ACS patients undergoing PCI, challenging the traditional view of CRP solely as a risk marker.
Higher hs-CRP may link to fewer MACCEs post-PCI in non-diabetic ACS; challenges CRP as adverse marker but leaves open causal role.
Background: C-reactive protein (CRP) plays a pivotal role in acute coronary syndrome(ACS) and diabetes mellitus (DM). Few data from non-diabetic ACS populations on the association of high-sensitivity CRP (hs-CRP) and long-term prognosis are available. This study aimed to investigate the relationship between baseline hs-CRP and the 2-year major cardiovascular and cerebrovascular adverse events (MACCEs) following percutaneous coronary intervention (PCI) of non-diabetic patients with ACS. Methods: We divided participants (n=419)into two groups according to baseline hs-CRP level to compare baseline characteristics and clinical outcomes. Cox regression and survival analysis of MACCE was performed at a median follow-up of 32.43 months. We also plot the receiver operating characteristics (ROC) curves of hs-CRP in predicting 2-year MACCEs. Results: The incidence of MACCEsin the lower-hs-CRP (L-CRP) (12.4%) group was higher than that in the higher-hs-CRP (H-CRP) (5.6%) group (P = 0.020). In COX regression analysis, the H-CRP (HR 0.975, 95% CI 0.637-0.992, P= 0.043) group was associated with lower MACCEs compared with the L-CRP group after adjusting for confounders. Conclusion: Elevated baseline hs-CRP levels may be a protector maker in predicting a lower incidence of MACCEs following PCI in ACS patients without glucose metabolism disorder.
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Zhang et al. (2022) conducted a cohort in Acute Coronary Syndrome (Non-diabetic) (n=419). Higher baseline hs-CRP level vs. Lower baseline hs-CRP level was evaluated on Major cardiovascular and cerebrovascular adverse events (MACCEs) (HR 0.795, 95% CI 0.637-0.992, p=0.043). Elevated baseline hs-CRP levels were associated with a significantly lower incidence of major cardiovascular and cerebrovascular adverse events (HR 0.795) following percutaneous coronary intervention in non-diabetic patients with acute coronary syndrome.
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