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Changes of High Sensitivity C-Reactive Protein During Clopidogrel Therapy in Patients Undergoing Percutaneous
Shokoufeh Hajsadeghi1, Mandana Chitsazan2, Mitra Chitsazan3
1Department of Cardiology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
Insights
Clopidogrel therapy in patients undergoing percutaneous coronary intervention (PCI) effectively reduces high sensitivity C-reactive protein (hs-CRP) levels. This anti-inflammatory effect is more pronounced in patients with co-morbidities like diabetes and hypertension.
Area of Science:
- Cardiology
- Inflammation Research
- Pharmacology
Background:
- Inflammation plays a key role in atherosclerosis development and progression.
- Limited data exists on high sensitivity C-reactive protein (hs-CRP) changes during clopidogrel therapy.
Purpose of the Study:
- To assess hs-CRP level changes during clopidogrel therapy in patients undergoing percutaneous coronary intervention (PCI).
- To evaluate potential anti-inflammatory effects of clopidogrel in different patient subgroups.
Main Methods:
- 650 patients undergoing elective, urgent, or emergent PCI were included.
- Patients received a clopidogrel loading dose and aspirin, followed by a 75-mg daily maintenance dose for 12 weeks.
- hs-CRP levels were reassessed at the 12-week follow-up.
Main Results:
- Female, hypertensive, diabetic, and non-smoking patients showed greater hs-CRP reduction with clopidogrel therapy (P < 0.005).
- Changes in hs-CRP levels varied significantly based on index events before PCI (P < 0.001).
- No significant difference in hs-CRP reduction was observed between patients with different stent types (P = 0.07).
Conclusions:
- Clopidogrel therapy demonstrates favorable effects in suppressing hs-CRP levels in patients undergoing PCI.
- The anti-inflammatory impact of clopidogrel is enhanced in patients with comorbidities such as diabetes and hypertension.
Background:
The crucial role of inflammation in the development and progression of atherosclerosis has been previously described. However, there is insufficient data available to demonstrate the changes in high sensitivity C-reactive protein (hs-CRP) during clopidogrel therapy.
Objectives:
In the present study, we aimed to assess the changes in the inflammatory marker of coronary heart disease, i.e., hs-CRP during clopidogrel therapy, in patients undergoing percutaneous coronary intervention (PCI). We also evaluated the anti-inflammatory effects of clopidogrel, if any, in different groups of patients.
Patients And Methods:
The study population included 650 consecutive patients who underwent elective, urgent, or emergent PCI. Patients received a 300-mg loading dose of clopidogrel (Plavix(®)) and aspirin either 24 hours before the planned PCI, or immediately before the procedure in patients with urgent or emergent PCI, followed by a 75-mg daily maintenance dose for up to 12 weeks. At the end of the 12(th) week, hs-CRP was re-assessed.
Results:
Six hundred-fifty patients including 386 (59.4%) male and 264 (40.6%) female subjects were enrolled in the study. The mean hs-CRP level was 15.36 ± 9.83 mg/L with a median of 14 mg/L (interquartile range 8 to 19.6 mg/L). Female, hypertensive, diabetic, and non-smoking patients had higher reductions in hs-CRP in response to clopidogrel therapy compared to male, non-hypertensive, non-diabetic and smoker patients, respectively (all P < 0.005). The changes in the hs-CRP levels were also statistically different in patients with various index events before PCI (P < 0.001). No significant differences were observed in the mean reduction of hs-CRP between the patients without stent implantation and those with bare metal or drug-eluting stents (P = 0.07), respectively.
Conclusions:
We found that the use of clopidogrel in patients undergoing PCI had favorable effects on the suppression of hs-CRP. This effect appears to be heightened and more apparent in some group of patients with co-morbidities such as diabetes and hypertension.
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