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Predictive value of C-reactive protein in patients with unstable angina pectoris undergoing coronary artery stent
I Karaca1, K Aydin, M Yavuzkir
1Department of Cardiology, Firat University School of Medicine, Elaziğ, Turkey. ilgink@yahoo.com
Insights
High C-reactive protein (CRP) levels after coronary stent implantation predict in-stent restenosis. A CRP value over 3 mg/l at three months strongly indicates restenosis risk.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- In-stent restenosis is a significant complication after coronary stent placement.
- Inflammation is recognized as a key factor contributing to in-stent restenosis.
Purpose of the Study:
- To assess C-reactive protein (CRP) as a predictive marker for in-stent restenosis.
- To evaluate CRP levels before and after coronary stent implantation in patients with unstable angina.
Main Methods:
- Prospective study of 86 patients with unstable angina undergoing successful stent implantation.
- Plasma CRP levels measured pre-procedure and at 48–72 hours, 1, 2, and 3 months post-procedure.
- In-stent restenosis defined as 50% angiographic loss at follow-up.
Main Results:
- Pre-procedural CRP had limited predictive value for 6-month in-stent restenosis (34% negative, 61% positive predictive values).
- A strong correlation was observed between 3-month post-procedural CRP and 6-month in-stent restenosis.
- The 3-month CRP measurement showed 8% negative and 76% positive predictive values for restenosis.
Conclusions:
- Elevated plasma CRP levels in the third month post-coronary stent implantation are a strong predictor of in-stent restenosis.
- A 3-month post-procedural CRP value exceeding 3 mg/l identifies patients at high risk for angiographic in-stent restenosis.
Abstract:
In-stent restenosis is a major problem following coronary stent implantation, and inflammation plays an active role. We evaluated the effectiveness of the inflammatory marker C-reactive protein (CRP) as a predictor of in-stent restenosis after successful stent implantation, in 86 patients with unstable angina pectoris. Plasma CRP was measured in all patients before the procedure, and at 48 - 72 h and 1, 2 and 3 months post-procedure. An angiographic loss of 50% at follow-up was accepted as in-stent restenosis. We found negative and positive predictive values of the pre-procedural plasma CRP for determining 6-month in-stent restenosis of 34% and 61%, respectively. We also found a strong correlation between the 3-month post-procedural CRP value and 6-month in-stent restenosis; the negative and positive predictive values being 8% and 76%, respectively. In conclusion, we showed that a plasma CRP value > 3 mg/l in the third month after coronary stent implantation was a strong predictor of angiographic in-stent restenosis.
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