An elevated value of C-reactive protein is the only predictive factor of restenosis after percutaneous coronary intervention.
BACKGROUND
The current techniques for percutaneous coronary interventions (PCI) remain limited by restenosis. Recent studies have provided evidence of inflammation playing a role in the pathogenesis of cardiovascular disease.


METHODS
Whether inflammatory markers are predictors of subsequent restenosis were prospectively tested in 272 consecutive patients with angiographically proven coronary artery disease. Patients having undergone PCI at Chonnam National University Hospital, between Sept. 1999 and Mar. 2001, were divided into two groups according to the occurrence of restenosis on a follow-up coronary angiogram: Group I were patients with restenosis (n = 99, 59.5 +/- 10.8 years, M:F = 77:22) and Group II were those without restenosis (n = 173, 58.8 +/- 10.2 years, M:F = 131:42). The IgG seropositivity, cytomegalovirus (CMV) titers, C. pneumoniae. H. pylori and levels of C-reactive protein (CRP) were compared between the two groups.


RESULTS
There were no statistical differences in the seropositivity of the CMV IgG C. pneumoniae IgG and H. pylori IgG between the two groups (Groups I vs. II: 100 vs. 100%, 24.7 vs. 25.7% and 62.2 vs. 63.7%, respectively). Of the angiographic parameters, a low Thrombolysis in Myocardial Infarction (TIMI) flow (TIMI 0 or 1) was more common in Group I than Group II (p = 0.038). The patients with an elevated CRP (> 0.5 mg/dL) were more common in Group I than Group II (57.6 vs. 36.4%, p = 0.001), with the CRP values being higher in Group I than Group II (3.3 +/- 5.8 vs. 1.3 +/- 2.6 mg/dL, p = 0.001). According to a multiple logistic regression analysis, the CRP was the only predictor of restenosis, with an odds ratio of 2.1169 (95% C.I. 1.2062-3.7154, p = 0.009).


CONCLUSIONS
The CRP value is the most important predictor of restenosis after PCI.
Jeong
Woo Kon
WK
Cardiac Catheterization Laboratory, Heart Center of Chonnam National University Hospital, Hakdong 8, Dong-gu, Gwangju, 501-757, Korea.
Jeong
Myung Ho
MH
Kim
Kye Hun
KH
Lee
Sang Rok
SR
Park
Ok Young
OY
Yum
Ju Hyup
JH
Kim
Joo Han
JH
Kim
Won
W
Rhew
Jae Young
JY
Ahn
Youn Keun
YK
Cho
Jeong Gwan
JG
Ahn
Byoung Hee
BH
Suh
Soon Pal
SP
Park
Jong Chun
JC
Kim
Sang Hyung
SH
Kang
Jung Chaee
JC
D015906:Angioplasty, Balloon, Coronary; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D016993:Chlamydophila pneumoniae / Q000276:immunology; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D003587:Cytomegalovirus / Q000276:immunology; D005260:Female; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D015415:Biomarkers; D002097:C-Reactive Protein