title: C-reactive protein and prognosis in women and men with coronary artery disease after percutaneous coronary intervention.
abstract: BACKGROUND
  Sex-based differences in the association between C-reactive protein (CRP) and cardiovascular events in patients with coronary artery disease (CAD) are incompletely investigated. We investigated whether there are gender differences in the association between CRP and outcome in patients with CAD after percutaneous coronary intervention (PCI).
  
  
  METHODS
  This study included 13,170 consecutive patients with CAD: 10,098 men and 3072 women. CRP was measured on admission in all patients. The primary outcome was 1-year mortality.
  
  
  RESULTS
  CRP level (median [25th-75th percentiles]) was higher in women than in men (3.08 [1.30-8.37] mg/L vs 2.30 [0.92-6.47] mg/L; P<0.001). CRP was >3mg/L in 4250 men (42.1%) and 1554 women (50.6%; P<0.001). One-year mortality was 4.9% (n=641 deaths). Deaths occurred in 318 men with CRP >3mg/L and 122 men with CRP ≤3mg/L (mortality estimates 7.7% and 2.1%, P<0.001) and in 154 women with CRP >3mg/L and 47 women with CRP ≤3mg/L (mortality estimates 10.1% and 3.2%, P<0.001). After adjustment in the Cox model, CRP was associated with increased risk of mortality in women (adjusted hazard ratio [HR]=1.03, 95% confidence interval [CI] 1.01-1.04, P<0.001 for each 5mg/L increase) and in men (adjusted HR=1.02 [1.01-1.03], P<0.001, for each 5mg/L increase). CRP predicted mortality with an area under the receiver-operating characteristic curve =0.721, [0.683-0.760] in women and 0.732, [0.707-0.757] in men (P=0.659).
  
  
  CONCLUSIONS
  Elevated CRP levels provide similar prognostic information in men and women with CAD after PCI which is independent and supplementary to that provided by conventional cardiovascular risk factors.
authors: Deutsches Herzzentrum München, Technische Universität, Lazarettstrasse 36, 80636, Munich, Germany. Electronic address: ndrepepa@dhm.mhn.de.
authors: Gjin
authors: G
authors: Ndrepepa
authors: Siegmund
authors: S
authors: Braun
authors: Salvatore
authors: S
authors: Cassese
authors: Massimiliano
authors: M
authors: Fusaro
authors: Lamin
authors: L
authors: King
authors: Adnan
authors: A
authors: Kastrati
authors: Roland
authors: R
authors: Schmidt
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D012372:ROC Curve; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: C-reactive protein; Coronary artery disease; Gender; Mortality