title: High-sensitivity C-reactive protein predicts 10-year cardiovascular outcome after percutaneous coronary intervention.
abstract: OBJECTIVE
  This study aimed to evaluate the prognostic value of high-sensitivity C-reactive protein (hsCRP) during 10-year follow-up after percutaneous coronary intervention (PCI).
  
  
  RESULTS
  Between April and October 2002, hsCRP was measured in 468 all-comer patients who underwent PCI with sirolimus-eluting stent implantation for stable coronary artery disease or acute coronary syndrome. The primary endpoint was the composite of all-cause mortality or myocardial infarction at 10-year follow-up. Kaplan-Meier event curves displayed ongoing divergence of the hsCRP groups (hsCRP <1 mg/L: 14.7% vs. 1-3 mg/L: 31.1% vs. >3 mg/L: 43.1%). After adjustment for established cardiovascular risk factors and clinical presentation in a Cox regression model, higher CRP levels were associated with a higher incidence of the composite endpoint (>3 mg/L vs. <1 mg/L: HR 2.87, 95% CI: 1.69-4.87, p<0.001; 1-3 mg/L vs. <1 mg/L: HR 2.30, 95% CI: 1.31-4.03, p=0.004). Although adding hsCRP to a prediction model containing conventional cardiovascular risk factors did not significantly improve discriminatory power (area under the receiver operating characteristic curve 0.71 to 0.73, p=0.56), hsCRP was able to improve risk classification (net reclassification index=0.40, p=<0.001).
  
  
  CONCLUSIONS
  In patients undergoing PCI, higher CRP levels at the time of the procedure are predictive for 10-year mortality and myocardial infarction. High-sensitivity CRP may be a useful biomarker to improve further risk assessment in patients undergoing PCI.
authors.affiliation: Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Rohit M
authors.initials: RM
authors.lastname: Oemrawsingh
authors.forename: Jin M
authors.initials: JM
authors.lastname: Cheng
authors.forename: K Martijn
authors.initials: KM
authors.lastname: Akkerhuis
authors.forename: Isabella
authors.initials: I
authors.lastname: Kardys
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Degertekin
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Joost
authors.initials: J
authors.lastname: Daemen
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein