C-reactive protein and myocardial infarction during percutaneous coronary intervention.
OBJECTIVE
To evaluate the prognostic information of preprocedural C-reactive protein (CRP) levels in serum to predict myocardial infarction during percutaneous coronary interventions (PCI).


METHODS
Prospective study.


METHODS
University hospital.


METHODS
A total of 400 consecutive patients with normal serum troponin T levels (</=0.03 microg L-1) presenting with stable or unstable angina pectoris.


METHODS
PCI.


METHODS
C-reactive protein levels in serum measured by a high sensitive method. Myocardial infarction defined as a serum troponin T elevation the day after PCI to a level >0.05 microg L-1.


RESULTS
Eighty-three patients (21%) experienced a myocardial infarction during PCI. The median value of CRP before the procedure was 1.83 (0.12-99.7) mg L-1. No difference was seen in CRP levels before PCI between patients without or with myocardial infarction during PCI. Multivariate analysis identified stent implantation (OR 2.68, 95% CI 1.18-7.28, P = 0.03), procedure time (OR 2.15, 95% CI 1.28-3.67, P < 0.005) and complications during the procedure (OR 3.62, 95% CI 1.72-7.58, P < 0.001) as independent predictors of myocardial infarction during PCI.


CONCLUSIONS
Increased CRP levels in serum before PCI were not associated with myocardial infarction during the procedure. Furthermore, patients with an expected long procedure and a high probability of stent implantation have an increased risk of developing myocardial infarction during PCI. This finding may be useful to help the operator to decide the antithrombotic regime before, during and after the procedure and the need for observation after the procedure.
Saleh
N
N
Department of Cardiology, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden. nawsad.saleh@ks.se
Svane
B
B
Velander
M
M
Nilsson
T
T
Hansson
L-O
LO
Tornvall
P
P
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology*; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D020107:Troponin T / Q000097:blood
D020107:Troponin T; D002097:C-Reactive Protein