Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation.
OBJECTIVE
To determine the association of preprocedural C reactive protein (CRP) levels with angiographic restenosis and adverse clinical events after drug-eluting stent (DES) implantation.


METHODS
A prospective cohort analysis of preprocedural CRP levels as a predictor of serious ischaemic complications or binary restenosis in patients treated with DES.


METHODS
Tertiary referral centre.


METHODS
1650 consecutive patients who underwent successful DES implantation. Patients were grouped into tertiles according to preprocedural CRP values for data analysis.


METHODS
Successful DES implantation.


METHODS
The primary end point was a major coronary event, defined as cardiac death or Q-wave myocardial infarction.


RESULTS
Baseline clinical and angiographic characteristics were similar between the tertile groups, except that more patients had multivessel disease and acute coronary syndrome with increasing tertiles of CRP levels. At 1-year follow-up, a primary end point occurred in 4 (0.7%) patients of the lowest tertile, in 3 (0.5%) patients of the middle tertile and in 16 (2.9%) patients of the highest tertile (p = 0.003). In multivariate analysis, the highest tertile of CRP levels was an independent predictor of a major coronary event (HR 4.68, 95% CI 1.91 to 11.44, tertile III vs tertiles I and II, p = 0.001). However, restenosis rates were similar in all three groups (9.1% vs 11.4% vs 11.6%, respectively, p = 0.3).


CONCLUSIONS
Preprocedural CRP levels are significantly associated with major coronary events after DES implantation. However, preprocedural CRP levels do not predict subsequent restenosis. Baseline CRP levels may be useful to guide adjunctive management for preventing serious ischaemic events in patients undergoing DES implantation.
Park
Duk-Woo
DW
Department of Medicine, Division of Epidemiology, University of Ulsan College of Medicine, Asan Medical Center, Poongnap-dong, Songpa-gu, Seoul, South Korea. sjpark@amc.seoul.kr
Lee
Cheol Whan
CW
Yun
Sung-Cheol
SC
Kim
Young-Hak
YH
Hong
Myeong-Ki
MK
Kim
Jae-Joong
JJ
Park
Seong-Wook
SW
Park
Seung-Jung
SJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000097:blood / Q000000981:diagnostic imaging; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D015607:Stents
D015415:Biomarkers; D002097:C-Reactive Protein; D017239:Paclitaxel