Related Experiment Video
Updated: Apr 4, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
C-reactive protein, renal function, and cardiovascular outcome in patients with symptomatic peripheral artery disease
Mislav Vrsalović1, Ksenija Vučur, Boris Car
1Mislav Vrsalović, Division of Angiology, Department of Cardiology, Sestre Milosrdnice University Hospital Centre, Vinogradska cesta 29, 10000 Zagreb, Croatia, mislav.vrsalovic@gmail.com.
Insights
Elevated C-reactive protein (CRP) and impaired renal function predict major adverse cardiovascular events (MACE) in patients with symptomatic peripheral artery disease (PAD) and preserved left ventricular ejection fraction (LVEF). These factors independently increase MACE risk, highlighting their prognostic importance.
Area of Science:
- Cardiology
- Nephrology
- Inflammation
Background:
- Peripheral artery disease (PAD) is a significant cardiovascular risk factor.
- Major adverse cardiovascular events (MACE) pose a threat to patients with PAD.
- The prognostic value of inflammatory markers and renal function in PAD with preserved ejection fraction requires further investigation.
Purpose of the Study:
- To determine the prognostic role of C-reactive protein (CRP) and renal function in predicting MACE.
- To assess these predictors in patients with symptomatic PAD and normal left ventricular ejection fraction (LVEF).
Main Methods:
- A cohort of 319 symptomatic PAD patients with preserved LVEF was studied.
- MACE occurrence (myocardial infarction, coronary revascularization, stroke, death) was tracked over a median of 24 months.
- Multivariate Cox regression analysis identified independent predictors of MACE, adjusting for various risk factors.
Main Results:
- 77 patients (24%) experienced MACE during follow-up.
- Independent predictors of MACE included older age, polyvascular disease, elevated CRP, and impaired renal function.
- Patients with both impaired renal function and high CRP had a 3.59-fold increased likelihood of MACE.
Conclusions:
- Elevated admission CRP levels are an independent predictor of MACE in PAD patients with preserved LVEF.
- Renal impairment is also an independent predictor of MACE in this patient group.
- Combined elevated CRP and renal impairment significantly increase MACE risk, underscoring their clinical importance.
Aim:
To investigate the prognostic role of C-reactive protein (CRP) and renal function for the occurrence of major adverse cardiovascular events (MACE) in patients with symptomatic peripheral artery disease (PAD) and preserved left ventricular ejection fraction (LVEF).
Methods:
The occurrence of MACE, defined as composite endpoint of acute myocardial infarction, urgent coronary revascularization, stroke, and death was assessed in 319 consecutive PAD patients admitted to the University Hospital between January 2010 and January 2014 (66.5% men, mean [±standard deviation] age 70±10 years, mean ankle brachial index 0.58±0.14) with normal LVEF (>50%). Multivariate Cox regression analysis adjusted for age, sex, traditional cardiovascular risk factors, anemia, polyvascular disease, critical limb ischemia (CLI), statin treatment, CRP (>5 mg/L), and impaired renal function (estimated glomerular filtration rate <60 mL/min) was applied to assess the independent predictors of MACE.
Results:
During median follow-up period of 24 months (interquartile range, 16-34 months), 77 patients (24%) experienced MACE. Compared to patients without MACE, these patients were older, more likely to have CLI, polyvascular disease, anemia, elevated CRP, and impaired renal function. In multivariate regression analysis, age (HR 1.04, 95% CI 1.01-1.07), polyvascular disease (HR 1.95, 95% CI 1.23-3.09), elevated CRP (HR 1.89, 95% CI 1.18-3.02), and impaired renal function (HR 1.68, 95% C 1.01-2.78) remained independent predictors of MACE. Patients with both impaired renal function and high CRP values on admission were 3.59 times more likely to experience MACE than patients with normal CRP and preserved renal function.
Conclusion:
Elevated admission CRP and renal impairment are independent predictors of MACE in symptomatic PAD patients with preserved LVEF.
Related Concept Videos
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:27Peripheral Artery Disease III: Interprofessional Care
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests