title: Response of serum C-reactive protein to percutaneous coronary intervention has prognostic value.
abstract: BACKGROUND
  Data are sparse regarding the association between C-reactive protein (CRP) and percutaneous coronary intervention (PCI) in long-term prognosis. Previous studies have shown that PCI evokes an inflammatory response. We tested the hypothesis that the CRP response to PCI has a prognostic value.
  
  
  METHODS
  We investigated 891 consecutive patients presenting with stable or unstable angina pectoris, with serum concentrations of cardiac troponin T < or =0.03 microg/L, who were undergoing a variety of PCIs. Serum concentrations of CRP and cardiac troponin T were determined before and the day after PCI. The mean follow-up time after PCI was 2.6 years, and the endpoint was death or nonfatal myocardial infarction.
  
  
  RESULTS
  Seventy-six patients reached the endpoint (4.6% death, 3.9% nonfatal myocardial infarction), whereas 21% developed myocardial infarction during the procedure. CRP increased more than 2-fold after the procedure. Patients in the third tertile of the CRP response to PCI had an increased risk for death or nonfatal myocardial infarction in multivariate analysis.
  
  
  CONCLUSIONS
  Increased serum CRP in response to PCI is an independent predictor of death or nonfatal myocardial infarction independent of myocardial injury during the procedure. CRP determinations might be of value in risk stratification after PCI.
authors.affiliation: Department of Cardiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden. nawzad.saleh@karolinska.se
authors.forename: Nawsad
authors.initials: N
authors.lastname: Saleh
authors.forename: Bertil
authors.initials: B
authors.lastname: Svane
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Hansson
authors.forename: Jens
authors.initials: J
authors.lastname: Jensen
authors.forename: Tage
authors.initials: T
authors.lastname: Nilsson
authors.forename: Olle
authors.initials: O
authors.lastname: Danielsson
authors.forename: Per
authors.initials: P
authors.lastname: Tornvall
mesh_terms: D000787:Angina Pectoris / Q000628:therapy; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000401:mortality*; D002097:C-Reactive Protein / Q000378:metabolism*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D018570:Risk Assessment
chemical_list: D002097:C-Reactive Protein