Relation of soft plaque and elevated preprocedural high-sensitivity C-reactive protein levels to incidence of in-stent restenosis after successful coronary artery stenting.
Although various predictors relating to in-stent restenosis (ISR) have been demonstrated, the relation between the parameters of intravascular ultrasound and inflammatory markers and ISR has not been reported. This study included 120 patients who underwent stent implantation for angiographically significant stenosis. Patients were divided into a soft plaque group (n = 50) and a nonsoft plaque group (n = 70). All patients underwent angiographic and intravascular ultrasound follow-up at 6 months. The baseline high-sensitivity C-reactive protein (hs-CRP) level was significantly higher in the soft plaque group. The follow-up minimal lumen diameter was significantly smaller in the soft plaque group. Soft plaque was detected in 73% of the ISR group but only 27% of the non-ISR group. Also, ISR was observed in 44% of the soft plaque group in contrast to only 11% of the nonsoft plaque group. The neointimal area at the minimal lumen cross-sectional area at follow-up was significantly larger in the soft plaque group (3.7 +/- 1.5 vs 1.9 +/- 1.5 mm2, p < 0.001). In conclusion, in patients with soft plaque, an elevated hs-CRP level was significantly associated with ISR (63% vs 15%, p < 0.001). By multivariate analysis, the combination of soft plaque and elevated hs-CRP was the most significant independent predictor of ISR.
Hong
Young Joon
YJ
Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Jeong
Myung Ho
MH
Lim
Sang Yup
SY
Lee
Sang Rok
SR
Hong
Seo Na
SN
Kim
Kye Hun
KH
Sohn
Il Suk
IS
Park
Hyung Wook
HW
Kim
Ju Han
JH
Kim
Weon
W
Ahn
Youngkeun
Y
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Kang
Jung Chaee
JC
D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D002097:C-Reactive Protein / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D023903:Coronary Restenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011475:Prosthesis Failure; D012189:Retrospective Studies; D015607:Stents; D018084:Ultrasonography, Interventional
D015415:Biomarkers; D002097:C-Reactive Protein