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Incremental prognostic value of high-sensitive C-reactive protein in patients undergoing coronary computed tomography

Won-Woo Seo1, Hack-Lyoung Kim2, Yong-Jin Kim3

  • 1Division of Cardiology, Kangdong Sacred Heart Hospital, Seoul, Republic of Korea; Hallym University College of Medicine, Seoul, Republic of Korea.

Journal of Cardiology
|October 21, 2015
PubMed

Insights

Combining high-sensitivity C-reactive protein (hs-CRP) testing with coronary computed tomography angiography (CCTA) significantly improves cardiovascular event prediction in patients with suspected coronary artery disease (CAD). This combined approach enhances risk stratification for better treatment strategies.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomarkers

Background:

  • Cardiovascular disease (CAD) remains a leading cause of mortality worldwide.
  • Accurate risk stratification is crucial for effective management of patients with suspected CAD.
  • Coronary computed tomography angiography (CCTA) is a key imaging modality for diagnosing CAD.

Purpose of the Study:

  • To evaluate the added prognostic value of high-sensitivity C-reactive protein (hs-CRP) levels combined with CCTA results.
  • To determine if this combination improves cardiovascular event prediction in patients with suspected CAD.
  • To assess the utility of hs-CRP for risk stratification in patients undergoing CCTA.

Main Methods:

  • A cohort of 445 patients with suspected CAD underwent both CCTA and hs-CRP measurement.
  • Cardiovascular events (cardiac death, myocardial infarction, unstable angina, late revascularization) were tracked.
  • Statistical analyses, including Kaplan-Meier and chi-square tests, were used to assess prognostic value.

Main Results:

  • Obstructive CAD (stenosis ≥50%) and high hs-CRP (≥2.25mg/L) were independent predictors of cardiovascular events.
  • The combination of hs-CRP and CCTA significantly increased predictive power (global chi-square ratio from 13.51 to 19.14, p=0.022).
  • Patients with both obstructive CAD and high hs-CRP had a 21.0-fold higher event risk compared to low-risk individuals (p=0.007).

Conclusions:

  • The combined use of hs-CRP levels and CCTA results significantly enhances prognostic power for cardiovascular events in patients with suspected CAD.
  • hs-CRP measurement offers a simple and valuable tool for risk stratification and guiding treatment strategies in patients undergoing CCTA.
  • This integrated approach aids in identifying high-risk individuals requiring more intensive management.
Abstract

Keywords:
Coronary computed tomography angiographyHigh-sensitivity C-reactive proteinPrognosis

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