title: Comparative prognostic value of low-density lipoprotein cholesterol and C-reactive protein in patients with stable coronary artery disease treated with percutaneous coronary intervention and chronic statin therapy.
abstract: BACKGROUND
  The comparative prognostic value of low density lipoprotein-cholesterol (LDL-C) and C-reactive protein (CRP) in patients with stable coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) and statin therapy is poorly investigated.
  
  
  METHODS
  The study included 7595 patients with stable CAD treated with PCI. Based on a cut-off of 100mg/dl for LDL-C and 3mg/L for CRP, patients were divided into 4 groups: patients with LDL-C≤100mg/dl and CRP≤3mg/L (n=2795); patients with LDL-C>100mg/dl and CRP≤3mg/L (n=2091); patients with LDL-C≤100mg/dl and CRP>3mg/L (n=1296); and patients with LDL-C>100mg/dl and CRP>3mg/L (n=1413). Statins at discharge were prescribed in all patients. The primary outcome was 1-year all-cause mortality.
  
  
  RESULTS
  One-year mortality was 2.1% (160 deaths): 1.2% (33 deaths) among patients with LDL-C ≤100mg/dl and CRP≤3mg/L, 1.4% (28 deaths) among patients with LDL-C>100mg/dl and CRP≤3mg/L, 4.8% (60 deaths) among patients with LDL-C≤100mg/dl and CRP>3mg/L and 2.9% (39 deaths) among patients with LDL-C>100mg/dl and CRP>3mg/L (P<0.001). After adjustment, CRP (hazard ratio [HR]=1.64, 95% confidence interval [CI] 1.33-2.02, for 1 standard deviation increase in the logarithmic scale) but not LDL-C (HR=1.03 [0.90-1.17], for 30mg/dl increase) showed an independent association with 1-year mortality. CRP (P=0.045) but not LDL-C (P=0.294) increased the discriminatory power of multivariable model for prediction of mortality.
  
  
  CONCLUSIONS
  In patients with stable CAD treated with PCI and statin therapy, CRP but not LDL-C was independently associated with increased risk of 1-year mortality.
authors.affiliation: Deutsches Herzzentrum München, Germany. Electronic address: ndrepepa@dhm.mhn.de.
authors.forename: Gjin
authors.initials: G
authors.lastname: Ndrepepa
authors.affiliation: Deutsches Herzzentrum München, Germany.
authors.forename: Siegmund
authors.initials: S
authors.lastname: Braun
authors.affiliation: Deutsches Herzzentrum München, Germany.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Tada
authors.affiliation: Deutsches Herzzentrum München, Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Guerra
authors.affiliation: Deutsches Herzzentrum München, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.affiliation: 1. Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.affiliation: Deutsches Herzzentrum München, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016009:Chi-Square Distribution; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; 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; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein
keywords: C-reactive protein; Coronary artery disease; Low density lipoprotein-cholesterol; Mortality