High residual inflammatory risk (hsCRP >2 mg/L) in stabilized AMI patients with optimal LDL control was independently associated with increased all-cause mortality (HR 4.33; 95% CI 2.37-7.90; p<0.001).
Cohort (n=661)
Yes
Does high residual inflammatory risk increase mortality and MACCE in stabilized AMI patients who have achieved optimal LDL control after PCI?
In AMI patients who achieve optimal LDL control post-PCI, residual inflammation (hsCRP >2 mg/L) remains a strong independent predictor of long-term mortality and adverse cardiovascular events.
Effect estimate: HR 4.33 (95% CI 2.37-7.90)
Absolute Event Rate: 43.1% vs 10.9%
p-value: p=<0.001
Abstract Objective This study aimed to evaluate the prognostic impact of high residual inflammatory risk (RIR) in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI) and achieved optimal low-density lipoprotein (LDL) control. Methods A retrospective analysis was conducted on successfully revascularized AMI patients from a large, prospective, multi-center PCI registry between 2004 and 2014. Patients with LDL ≤70 mg/dL at 1-year follow up and serial high-sensitivity C-reactive protein (hsCRP) measurements at baseline and 1 year were included. High RIR was defined as hsCRP 2 mg/L at 1 year. The primary endpoint was all-cause mortality, and secondary endpoints were major adverse cardiac and cerebrovascular events (MACCE). Results Of the 661 patients, 129 (19.5%) had high RIR. The high RIR group had significantly higher mortality rates (43.1 per 1,000 patient-years) compared to the low RIR group (10.9 per 1,000 patient-years; p0.001). After multivariable adjustment, high RIR remained independently associated with increased mortality (HR 4.33, 95% CI 2.37-7.90; p0.001) and a higher risk of MACCE (HR 2.99, 95% CI 1.87-4.76; p0.001). Conclusions In stabilized AMI patients with optimal LDL control after PCI, high RIR is a significant predictor of increased mortality and a higher risk of MACCE. Reducing residual inflammation may improve long-term outcomes following PCI in these patients.
Lee et al. (Sat,) conducted a cohort in Acute myocardial infarction (AMI) (n=661). High residual inflammatory risk (hsCRP >2 mg/L) vs. Low residual inflammatory risk was evaluated on All-cause mortality (HR 4.33, 95% CI 2.37-7.90, p=<0.001). High residual inflammatory risk (hsCRP >2 mg/L) in stabilized AMI patients with optimal LDL control was independently associated with increased all-cause mortality (HR 4.33; 95% CI 2.37-7.90; p<0.001).