Relation of number of complex coronary lesions to serum C-reactive protein levels and major adverse cardiovascular events at one year.
This study investigated the relation among serum C-reactive protein (CRP), number of complex coronary lesions, and adverse cardiovascular events at 1 year. Univariate and multivariate analyses were performed. Of 283 patients who had acute coronary syndrome, a single complex lesion was present in 32%, multiple complex lesions were identified in 23%, and no complex lesion was documented in 45%. On multivariate analysis, CRP was independently associated with the presence of multiple complex coronary lesions (p <0.0001); there was a striking association between increments in CRP titers and number of complex lesions (CRP levels of 0.22 mg/dl in patients who had 0 lesion, 0.53 mg/dl in patients who had 1 lesion, and 1.85 mg/dl in patients who had multiple complex lesions, p <0.0001), and high serum CRP levels independently predicted adverse outcome (p = 0.03). In conclusion, the presence of multiple complex plaques was the most powerful predictor of adverse outcome (hazard ratio 2.88, p = 0.0007), predominantly in those who had high CRP levels (p = 0.004).
Goldstein
James A
JA
William Beaumont Hospital, Royal Oak, Michigan, USA. hgoldstein@beaumont.edu
Chandra
Harish R
HR
O'Neill
William W
WW
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
D015415:Biomarkers; D002097:C-Reactive Protein