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Independent Prognostic Value of High-sensitivity C-reactive Protein in Patients with Coronary Artery Ectasia
Yintang Wang1, Yang Wang2, Shijie You1
1Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China.
Insights
High-sensitivity C-reactive protein (hs-CRP) predicts adverse cardiovascular events in coronary artery ectasia (CAE). Elevated hs-CRP levels identify patients at higher risk for cardiac death and myocardial infarction, aiding in risk stratification.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Research
Background:
- Coronary artery ectasia (CAE) is a severe cardiovascular condition with limited understanding.
- High-sensitivity C-reactive protein (hs-CRP) is a known prognostic factor in cardiovascular diseases, but its role in CAE is unexamined.
Purpose of the Study:
- To investigate the prognostic value of hs-CRP in patients with coronary artery ectasia (CAE).
- To assess if hs-CRP can predict cardiovascular events in stable CAE patients.
Main Methods:
- Observational study analyzing baseline hs-CRP levels and subsequent cardiovascular events (CVs) in stable CAE patients.
- Utilized Cox proportional hazards regression, Kaplan-Meier analysis, and assessed net reclassification improvement and integrated discrimination improvement (IDI).
Main Results:
- Multivariable Cox analysis revealed hs-CRP as a significant predictor of adverse outcomes in CAE (HR: 2.99, P=0.0091).
- Patients with hs-CRP >3 mg/L showed lower event-free survival and higher CV risk (HR=2.66, P=0.0140).
- Hs-CRP provided additional predictive information beyond classical risk factors (IDI P=0.0330).
Conclusions:
- Elevated hs-CRP levels are independently associated with cardiac death and nonfatal myocardial infarction in CAE patients.
- Hs-CRP can offer valuable prognostic information for risk stratification in CAE patients.
Background:
Despite its severity, coronary artery ectasia (CAE) is still poorly understood. High-sensitivity C-reactive protein (hs-CRP) has been recognized as a prognostic factor in some cardiovascular diseases but not assessed in CAE. The aim of this observational study was to investigate the prognostic value of hs-CRP in CAE.
Methods:
Our analysis evaluated the effect of the baseline hs-CRP on cardiovascular events (CVs) (cardiac death and nonfetal myocardial infarction) in consecutively enrolled stable CAE patients. We used the Cox proportional hazards regression models to examine the association between baseline hs-CRP level and follow-up CVs in CAE. The net reclassification improvement and integrated discrimination improvement (IDI) of hs-CRP were also assessed.
Results:
We obtained the follow-up results of 540 patients over a median follow-up period of 36 (37.41 ± 15.88) months. The multivariable Cox analysis showed that the hs-CRP was a significant predictor of adverse outcomes in CAE (hazard ratio [HR]: 2.99, 95% confidence interval [CI]: 1.31-6.81, P = 0.0091). In Kaplan-Meier analysis, the group with hs-CRP >3 mg/L had a lower cumulative 66-month event-free survival rate (log-rank test for trend, P = 0.0235) and a higher risk of CVs (HR = 2.66, 95% CI: 1.22-5.77, P = 0.0140) than the group with hs-CRP ≤3 mg/L. Hs-CRP added predictive information beyond that given by the baseline model comprising the classical risk factors (P value for IDI = 0.0330).
Conclusions:
A higher level of hs-CRP was independently associated with cardiac death and nonfatal myocardial infarction in CAE patients. The hs-CRP level may therefore provide prognostic information for the risk stratification of CAE patients.
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