Patients with elevated CRP after elective coronary stenting exhibited significantly higher maximal plasma fibrin clot strength compared to those with low CRP (3438 vs 2184 dyn/cm, P<0.0001).
Cross-Sectional (n=54)
Is elevated C-reactive protein associated with increased plasma fibrin clot strength in patients after elective coronary stenting?
Elevated CRP after elective PCI is associated with heightened maximal plasma fibrin clot strength independent of fibrinogen concentration, suggesting a link between inflammation and hypercoagulability.
Absolute Event Rate: 3438% vs 2184%
p-value: p=<0.0001
Inflammation is implicated in the progression of coronary artery disease and the molecular processes of inflammation and thrombosis are closely intertwined. Elevated levels of C-reactive protein (CRP) have been associated with an elevated risk of adverse ischaemic events after coronary stenting and hypercoagulability. Heightened whole blood clot strength measured by thrombelastography (TEG) has been associated with adverse ischaemic events after stenting. We intended to examine the relationship of CRP to plasma fibrin clot strength in patients after coronary stenting. Plasma fibrin clot strength was measured by TEG in 54 patients 16-24 h after undergoing elective percutaneous coronary intervention (PCI). Coagulation was induced in citrated plasma by addition of kaolin and CaCl2. Plasma levels of CRP and fibrinogen were measured by enzyme-linked immunoassay. Increasing quartiles of CRP were associated with increasing levels of maximal plasma fibrin clot strength measured by TEG (P < 0.001) and increasing BMI (P = 0.04). Patients in the highest quartile of CRP had significantly higher maximal fibrin clot strength (G) than the patients in the lowest quartile (G: 3438 ± 623 vs. 2184 ± 576 dyn/cm, P < 0.0001). Fibrinogen concentration was not significantly different across quartiles of CRP (P = 0.97). Patients with established coronary artery disease undergoing coronary stenting who have elevated CRP after PCI exhibit heightened maximal plasma fibrin clot strength as compared with those with low CRP. Thrombotic risk associated with elevated CRP may be linked to procoagulant changes and high tensile fibrin clot strength independent of fibrinogen concentration.
Kreutz et al. (Fri,) conducted a cross-sectional in Coronary artery disease post-stenting (n=54). Highest quartile of C-reactive protein (CRP) vs. Lowest quartile of CRP was evaluated on Maximal plasma fibrin clot strength (G) (p=<0.0001). Patients with elevated CRP after elective coronary stenting exhibited significantly higher maximal plasma fibrin clot strength compared to those with low CRP (3438 vs 2184 dyn/cm, P<0.0001).