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C-reactive protein as a predictor for poor collateral circulation in patients with chronic stable coronary heart
Ying Fan1,2, Sha Li1, Xiao-Lin Li1
1a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital , National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China ;
Insights
Elevated C-reactive protein (CRP) levels are linked to poor coronary collateral circulation (CCC) in Chinese patients with severe coronary stenosis. Higher CRP concentrations independently predict impaired collateral development, suggesting CRP as a potential biomarker for cardiovascular risk.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Coronary artery disease (CAD) poses a significant global health burden.
- Coronary collateral circulation (CCC) plays a crucial role in mitigating ischemic damage.
- C-reactive protein (CRP) is a known marker of inflammation and a predictor of cardiovascular events.
Purpose of the Study:
- To investigate the association between serum C-reactive protein (CRP) levels and coronary collateral circulation (CCC).
- To assess CRP as a potential predictor of poor CCC in Chinese patients with severe coronary stenosis (≥95%).
Main Methods:
- 1158 patients with ≥95% coronary stenosis were enrolled.
- Patients were classified into poor CCC (Rentrop grades 0-1) and good CCC (Rentrop grades 2-3) groups.
- Serum CRP levels were analyzed and correlated with CCC status using statistical models.
Main Results:
- Significant differences in CRP levels were observed between poor and good CCC groups (5.76 vs. 3.49 mg/L, p<0.001).
- Higher CRP tertiles were associated with increased odds of poor CCC (OR 2.31 and 6.25).
- Optimal CRP cutoff for predicting poor CCC was 4.21 mg/L (sensitivity 59.6%, specificity 74.33%).
Conclusions:
- Serum CRP levels are an independent predictor of poor coronary collateral circulation.
- Elevated CRP is associated with impaired collateral development in severe coronary stenosis.
- CRP may serve as a valuable biomarker in clinical applications for assessing cardiovascular risk.
Aim:
To investigate the association between serum C-reactive protein (CRP) levels and coronary collateral circulation (CCC) in Chinese patients with angiography-proven ≥95% coronary stenosis.
Methods:
In this study, 1158 patients with angiography-proven ≥95% occlusion in ≥1 major epicardial coronary artery were enrolled, and then classified into two groups: poor CCC (Rentrop grades 0-1) and good CCC (Rentrop grades 2-3). CRP levels were grouped using the following two models: Model 1 discretized CRP group with 33.33% and 66.66% as the critical values and Model 2 with 1.0 and 3.0 mg/L as the cut off values.
Results:
There were significant differences in serum CRP levels between the two groups (5.76 ± 3.45 vs. 3.49 ± 2.44 mg/L, respectively; p < 0.001), and compared with the first CRP tertile, the risks of poor CCC were higher in the second and third CRP tertiles (OR 2.31, 95%CI [1.67-3.19], OR 6.25, 95%CI [4.52-8.62], respectively). The receiver operating characteristic curve analysis indicated that the optimal cutoff value of CRP to predict poor CCC was 4.21 mg/L with 59.6% sensitivity and 74.33% specificity.
Conclusions:
CRP levels are an independent predictor for poor CCC and might supply a useful biomarker in clinical applications. Key messages C-reactive protein (CRP) is a non-specific inflammatory marker that is regarded as an independent risk and prognostic factor for individuals who suffer from coronary artery disease (CAD) and cardiovascular disorders. In a Chinese cohort of patients with coronary artery occlusion or stenosis of ≥95% TIMI grade 1 anterograde-flow, the relationship between CRP concentrations and angiographically visible coronary collateral (CC) was assessed. Our data indicated that elevated CRP associated with a significant impairment in CC development, and might supply a useful biomarker in clinical applications.
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