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Published on: January 28, 2020
[The high-sensitivity C-reactive protein level one month after bare-metal coronary stenting may predict late adverse
Juan-Antonio Fournier1, Carmen Delgado-Pecellín, Aurelio Cayuela
1Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, España. jafournier@gmail.com
Insights
High-sensitivity C-reactive protein (hs-CRP) levels 30 days post-PCI predict cardiac events. Lower hs-CRP levels correlate with better event-free survival after stenting.
Area of Science:
- Cardiology
- Biomarkers
- Interventional Cardiology
Context:
- Percutaneous coronary interventions (PCIs) are common procedures.
- The prognostic value of high-sensitivity C-reactive protein (hs-CRP) after PCI remains uncertain.
- Bare-metal stents are frequently used in PCI procedures.
Purpose:
- To investigate the predictive significance of hs-CRP levels in patients undergoing PCI.
- To determine if hs-CRP levels can identify patients at risk for adverse cardiac events post-stenting.
Summary:
- hs-CRP and Troponin-T levels were monitored in 68 patients before and after PCI with bare-metal stents.
- Elevated hs-CRP levels at 24 hours and 30 days post-PCI were associated with adverse events.
- hs-CRP levels at 30 days demonstrated high sensitivity (80%) and specificity (72%) for predicting events.
- Event-free survival at 12 months was significantly better for patients with hs-CRP ≤2.5 mg/L at 30 days.
Impact:
- Measuring hs-CRP 30 days after stenting may aid in predicting late adverse cardiac events.
- This finding could refine risk stratification and patient management following PCI.
- hs-CRP serves as a valuable prognostic biomarker in the context of coronary stenting.
Abstract:
The significance of the high-sensitivity C-reactive protein (hs-CRP) level in percutaneous coronary interventions (PCIs) is unclear. Troponin-T and hs-CRP levels were measured before PCI, after stenting, and 8 h, 24 h, and 30 days after the procedure in 68 consecutive patients who received bare-metal stents. The study endpoints were death, nonfatal myocardial infarction, and the need for revascularization. The mean follow-up time after PCI was 16.6 months. Patients who experienced an event had higher hs-CRP levels 24 h (P=.05) and 30 days (P< .02) after stenting. The area under the receiver operating characteristic (ROC) curve at 30 days had the highest sensitivity (i.e., 80%) and specificity (i.e., 72%) for predicting an event. The 12-month event-free survival rate (Kaplan-Meier) was greater when the hs-CRP level at 30 days was < or =2.5 mg/L than when it was above this value (P=.04). Consequently, measuring the hs-CRP level 30 days after stenting may be useful for predicting late events.
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