title: Impact of preprocedural high-sensitive C-reactive protein levels on long-term clinical outcomes of patients with stable coronary artery disease and chronic kidney disease who were treated with drug-eluting stents.
abstract: BACKGROUND
  To evaluate the prognostic impact of preprocedural high-sensitivity C-reactive protein (hsCRP) levels on the long-term clinical outcomes after first-generation drug-eluting stent (DES) implantation in chronic kidney disease (CKD) patients with stable coronary artery disease (CAD).
  
  
  RESULTS
  We found significant interaction between CKD and hsCRP levels (p=0.0138) in 1176 consecutive patients with stable CAD who were treated with first-generation DES implantation between 2004 and 2009 at our institution. Therefore, we separately analyzed data from patients with and without CKD who were assigned to tertiles based on preprocedural hsCRP levels. We evaluated the incidence of major adverse cardiovascular events (MACE) comprising all-cause death, nonfatal myocardial infarction, and target vessel revascularization after percutaneous coronary intervention during a median follow-up period of 1266 days. The rate of MACE significantly differed among the tertiles (log-rank p=0.0074) in the group with CKD. Multivariate Cox regression analysis significantly associated a higher hsCRP tertile with MACE in the CKD group (hazard ratio 2.39, 95% confidence interval 1.27-4.75, p=0.0062).
  
  
  CONCLUSIONS
  Elevated preprocedural serum hsCRP levels might be associated with the long-term clinical outcomes of patients with stable CAD and CKD who were implanted with first-generation DES.
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan. Electronic address: ktmmy@med.juntendo.ac.jp.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Doi
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Wada
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Naito
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Konishi
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Shuta
authors.initials: S
authors.lastname: Tsuboi
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.affiliation: Juntendo University, Department of Cardiovascular Medicine, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein
keywords: Chronic kidney disease; Coronary artery disease; Drug-eluting stents; High-sensitive C-reactive protein