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Updated: Aug 23, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Preprocedural C-reactive protein is not associated with angiographic restenosis or target lesion revascularization
Saskia Z H Rittersma1, Robbert J de Winter, Karel T Koch
1Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands.
Insights
Preprocedural C-reactive protein (CRP) levels do not predict in-stent restenosis after coronary stenting. However, statin therapy independently reduces the need for repeat procedures, highlighting its clinical benefit.
Area of Science:
- Cardiology
- Biomarkers
- Interventional Cardiology
Background:
- Assessing the predictive value of preprocedural plasma C-reactive protein (CRP) concentrations and statin therapy.
- Evaluating their impact on 6-month angiographic and 1-year clinical outcomes following non-urgent coronary stent placement.
Purpose of the Study:
- To determine if preprocedural C-reactive protein (CRP) levels predict in-stent restenosis (ISR) and clinical outcomes after coronary stenting.
- To investigate the association between statin therapy and ISR and clinical outcomes post-stent placement.
Main Methods:
- Prospective measurement of high-sensitivity CRP in 345 patients undergoing elective stent placement.
- Analysis of angiographic in-stent restenosis (ISR) rates and clinical outcomes at 6 months and 1 year.
- Multivariate logistic regression to identify independent predictors of ISR and target lesion revascularization.
Main Results:
- No significant association was found between CRP levels and angiographic ISR or clinically driven target lesion revascularization.
- Patients with abnormal CRP showed a trend toward higher risk of nonfatal myocardial infarction.
- Statin therapy was independently associated with decreased clinically driven target lesion revascularization (OR = 0.26; 95% CI, 0.09-0.68).
Conclusions:
- Preprocedural CRP concentrations lack predictive value for angiographic ISR or clinically driven target lesion revascularization.
- Abnormal CRP levels may indicate a trend towards increased risk of nonfatal myocardial infarction.
- Statin therapy demonstrates a significant beneficial effect on clinical outcomes, reducing the need for target lesion revascularization.
Background:
We assessed the predictive value of preprocedural plasma C-reactive protein (CRP) concentrations and statin therapy on 6 months angiographic and 1-year clinical outcome after nonurgent coronary stent placement.
Methods And Results:
Baseline plasma high-sensitivity CRP concentrations were prospectively measured in 345 patients undergoing elective stent placement in a native coronary artery. The binary angiographic in-stent restenosis (ISR; stenosis > or = 50% of vessel diameter) rate was 19% in patients with CRP values within the reference interval (< or = 3 mg/L) and 22% in patients with CRP >3 mg/L [odds ratio (OR) = 1.2; 95% confidence interval (CI), 0.73-2.09]. Statin therapy in a univariate analysis significantly reduced both angiographic and clinical ISR rates. Multivariate logistic regression analysis identified unstable angina, smoking, and stent length, but neither CRP concentration nor statin therapy as independent predictors for angiographic ISR. Patients with an abnormal CRP value showed a trend toward a higher risk of nonfatal myocardial infarction (3.8% vs 0.5%; OR = 7.43; 95% CI, 0.87-61.65). Target lesion revascularization rates did not differ between the two groups (9.6% vs 10.6%; OR = 1.13; 95% CI, 0.56-2.28). In multivariate analysis, male sex (OR = 0.44, 95% CI, 0.19-0.97) and statin therapy (OR = 0.26; 95% CI, 0.09-0.68) were independent predictors for the occurrence of target lesion revascularization.
Conclusions:
This study demonstrated a lack of association between preprocedural plasma CRP concentrations and angiographic coronary ISR or clinically driven target lesion revascularization. Patients with an abnormal CRP concentration showed a trend toward higher risk of nonfatal myocardial infarction during 1 year of follow-up. Statin therapy was independently associated with decreased clinically driven target lesion revascularization, underlining the beneficial effects of statins on clinical outcome.