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Relationship Between High-Sensitivity C-Reactive Protein and Long-Term Outcomes in Elderly Patients With 3-Vessel

Yue Liu1, Ce Zhang1, Lin Jiang1

  • 134736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.

Angiology
|June 10, 2021
PubMed

Insights

High-sensitivity C-reactive protein (hsCRP) is a valuable predictor of long-term adverse outcomes, including death and major cardiovascular events, in elderly patients with complex coronary artery disease.

Area of Science:

  • Cardiology
  • Biomarkers
  • Geriatric Medicine

Background:

  • The prognostic significance of high-sensitivity C-reactive protein (hsCRP) in complex coronary artery disease (CAD) remains incompletely understood.
  • Elderly patients with 3-vessel disease (TVD) represent a vulnerable population where accurate risk stratification is crucial.

Purpose of the Study:

  • To investigate the association between hsCRP levels and long-term clinical outcomes in elderly patients diagnosed with TVD.
  • To evaluate hsCRP as an independent predictor of mortality and major adverse cardiovascular and cerebrovascular events (MACCE) in this cohort.

Main Methods:

  • A cohort of 3069 elderly patients (≥65 years) with TVD were enrolled between April 2004 and February 2011.
  • Patients were stratified into two groups based on hsCRP levels: <3.00 mg/L and ≥3.00 mg/L.
  • Median follow-up was 6.2 years, with outcomes including all-cause death, cardiac death, and MACCE analyzed using multivariable Cox regression.

Main Results:

  • Elevated hsCRP (≥3.00 mg/L) was significantly associated with increased risks of all-cause death (29.6% vs 19.5%), cardiac death (15.2% vs 9.4%), and MACCE (42.5% vs 34.1%).
  • hsCRP emerged as an independent predictor for these adverse events.
  • Combining hsCRP with the SYNTAX Score II improved the predictive capability for adverse outcomes.

Conclusions:

  • hsCRP is a significant and independent predictor of long-term mortality and MACCE in elderly patients with TVD.
  • hsCRP can enhance risk stratification strategies, particularly when integrated with existing clinical scores like SYNTAX Score II.
  • These findings support the utility of hsCRP measurement for guiding risk assessment and management decisions in older adults with complex coronary artery disease.

Keywords:
agecoronary artery diseasehigh-sensitivity C-reactive proteininflammationprognosisrevascularization

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