Key result
An increased serum CRP response to PCI (third tertile) was an independent predictor of death or nonfatal myocardial infarction, which occurred in 76 of 891 patients (8.5%).
Why the study?
Does an increased CRP response to PCI predict death or nonfatal myocardial infarction in patients with stable or unstable angina?
Cohort (n=891)
Does an increased CRP response to PCI predict death or nonfatal myocardial infarction in patients with stable or unstable angina?
An increased serum CRP response following PCI is an independent predictor of long-term death or nonfatal myocardial infarction, suggesting its utility in risk stratification.
Elevated post-PCI CRP may support risk stratification in angina; leaves open prospective validation before guiding therapy.
BACKGROUND: Data are sparse regarding the association between C-reactive protein (CRP) and percutaneous coronary intervention (PCI) in long-term prognosis. Previous studies have shown that PCI evokes an inflammatory response. We tested the hypothesis that the CRP response to PCI has a prognostic value. METHODS: We investigated 891 consecutive patients presenting with stable or unstable angina pectoris, with serum concentrations of cardiac troponin T < or =0.03 microg/L, who were undergoing a variety of PCIs. Serum concentrations of CRP and cardiac troponin T were determined before and the day after PCI. The mean follow-up time after PCI was 2.6 years, and the endpoint was death or nonfatal myocardial infarction. RESULTS: Seventy-six patients reached the endpoint (4.6% death, 3.9% nonfatal myocardial infarction), whereas 21% developed myocardial infarction during the procedure. CRP increased more than 2-fold after the procedure. Patients in the third tertile of the CRP response to PCI had an increased risk for death or nonfatal myocardial infarction in multivariate analysis. CONCLUSIONS: Increased serum CRP in response to PCI is an independent predictor of death or nonfatal myocardial infarction independent of myocardial injury during the procedure. CRP determinations might be of value in risk stratification after PCI.
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Saleh et al. (2005) conducted a cohort in Stable or unstable angina pectoris undergoing PCI (n=891). Increased serum CRP response to PCI vs. Lower CRP response was evaluated on Death or nonfatal myocardial infarction. An increased serum CRP response to PCI (third tertile) was an independent predictor of death or nonfatal myocardial infarction, which occurred in 76 of 891 patients (8.5%).
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