A persistent increase in C-reactive protein is a risk factor for restenosis in patients with stable angina who are not receiving statins.
Inflammation has been postulated to be a major contributor to restenosis after angioplasty. We examined the correlation between inflammatory and coagulatory reactions and the occurrence of restenosis, and how treatment with statins influences this correlation. A total of 243 patients with stable angina who were scheduled for a percutaneous coronary intervention (PCI) and follow-up coronary angiography were enrolled in the study. Eighty-one of these patients were treated with statins for at least 1 month before their PCI and throughout the study period. Blood was withdrawn on the day of the PCI and on the day of the follow-up catheterization. Patients with the highest hs-CRP at the time of the initial PCI maintained elevated hs-CRP levels over time and showed significantly higher rates of restenosis or TLR after 6 +/- 1 months than subjects with low initial hs-CRP. Statin treatment abolished this difference. Fibrinogen levels were also increased in subjects with high initial hs-CRP, both at the time of the initial PCI and at follow-up. In an univariate analysis, both initial and follow-up levels of hs-CRP and fibrinogen correlated with restenosis. However, both the initial and follow-up levels of hs-CRP only were independent predictors of increased restenosis in a multivariate analysis, except in the statin-treated subgroup. In conclusions, the persistent increase in CRP is a risk factor for restenosis in patients with stable angina who have not been treated with statins.
Hoshida
Shiro
S
Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. hoshidas@city.yao.osaka.jp
Nishino
Masami
M
Takeda
Toshihiro
T
Tanouchi
Jun
J
Yamada
Yoshio
Y
Hori
Masatsugu
M
D000368:Aged; D000704:Analysis of Variance; D000787:Angina Pectoris / Q000175:diagnosis* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D002097:C-Reactive Protein / Q000032:analysis*; D015331:Cohort Studies; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D015994:Incidence; D018836:Inflammation Mediators / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D002097:C-Reactive Protein