Increased circulating C-reactive protein and macrophage-colony stimulating factor are complementary predictors of long-term outcome in patients with chronic coronary artery disease.
OBJECTIVE
We investigated, in a 6 year follow-up study, whether circulating levels of C-reactive protein (CRP) and macrophage colony stimulating factor (MCSF) have an independent or complementary prognostic value in patients with chronic coronary artery disease (CAD).


RESULTS
MCSF and CRP were measured in 100 patients with chronic CAD. Of 95 (33%) patients, 31 who completed the 6 year follow-up presented adverse events (death, myocardial infarction, and unstable angina). In multivariable analysis (including traditional risk factors and medications), the upper tertiles of MCSF (> or =814 pg/mL) and CRP (> or =2.5 mg/L) levels were independently associated with a 13- and 6-fold increase in risk of events, respectively (P<0.01). Patients with combined high CRP and MCSF had a higher absolute risk of events than patients with elevated MCSF or CRP alone (75 vs. 59 vs. 32%, respectively, P<0.01). The mean event-free time was 39, 64, and 52 months in patients with elevated MCSF, elevated CRP, and their combination, respectively.


CONCLUSIONS
In patients with chronic CAD, the prognostic value of MCSF is independent and complementary to that of CRP. MCSF is a particularly useful prognostic marker when CRP levels are low, but also provides additional information concerning risk and time-course of events in patients with elevated CRP.
Ikonomidis
Ignatios
I
Department of Clinical Therapeutics, University of Athens, Alexandra Hospital, Vas. Sofias 80, Athens 11528, Greece. ignoik@otenet.gr
Lekakis
John
J
Revela
Ioanna
I
Andreotti
Felicita
F
Nihoyannopoulos
Petros
P
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000097:blood*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D016173:Macrophage Colony-Stimulating Factor; D002097:C-Reactive Protein