Abstract
Purpose
To investigate the prognostic value of elevated C-reactive protein levels in patients
with stable angina who underwent coronary stenting.
Methods
We followed a consecutive series of 1152 patients with stable angina who had undergone
coronary stenting. We measured baseline C-reactive protein levels before stenting
with a high-sensitivity assay; 651 patients (57%) had elevated C-reactive protein
levels (>5 mg/L). The primary endpoint was either death or myocardial infarction within
1 year after the procedure. Angiographic restenosis was defined as a ≥50% diameter
stenosis at follow-up angiography.
Results
During the 1-year follow-up, 62 (9.5%) of the 651 patients with an elevated C-reactive
protein level and 24 (4.8%) of the 501 patients with normal levels died or had a myocardial
infarction (P = 0.002). In a multivariate analysis, elevated baseline C-reactive protein levels
were associated with almost a twofold increase in the rate of death or myocardial
infarction after coronary stenting (hazard ratio = 1.8; 95% confidence interval: 1.1
to 2.9). Most of the difference in the event rates developed within the first 30 days.
Baseline C-reactive protein levels did not correlate with restenosis.
Conclusion
Elevated preprocedural C-reactive protein levels are associated with a less favorable
prognosis in patients with stable angina who undergo coronary stenting. The measurement
of C-reactive protein levels in these patients may help to identify those who may
benefit from a treatment strategy aimed at the attenuation of inflammation.
Keywords
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Article info
Publication history
Accepted:
February 3,
2003
Received:
September 20,
2002
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
