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Prognostic Value of Baseline Inflammation in Diabetic and Nondiabetic Patients Undergoing Percutaneous Coronary

Carlo Andrea Pivato1, Davis Jones2, Davide Cao3

  • 1Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy.

The Canadian Journal of Cardiology
|February 13, 2022
PubMed

Insights

High-sensitivity C-reactive protein (hsCRP) levels predict worse outcomes after percutaneous coronary intervention (PCI) for both diabetic and nondiabetic patients. Elevated hsCRP indicates increased risk of major adverse cardiovascular events, including death, myocardial infarction, and revascularization.

Area of Science:

  • Cardiology
  • Biomarkers
  • Interventional Cardiology

Background:

  • Limited data exists on the prognostic significance of high-sensitivity C-reactive protein (hsCRP) in patients undergoing percutaneous coronary intervention (PCI).
  • The role of hsCRP as a predictor of outcomes in diabetic versus nondiabetic patients undergoing PCI requires further investigation.

Purpose of the Study:

  • To evaluate the prognostic value of high hsCRP levels in diabetic and nondiabetic patients undergoing PCI.
  • To determine if hsCRP levels predict major adverse cardiovascular events (MACE) after PCI, considering diabetes status.

Main Methods:

  • A cohort of 11,979 patients undergoing PCI between 2010 and 2017 with known baseline hsCRP levels were analyzed.
  • High hsCRP was defined as > 3 mg/L; patients with hsCRP > 10 mg/L or known secondary causes of inflammation were excluded.
  • The primary outcome was 1-year MACE, comprising all-cause mortality, myocardial infarction (MI), and target-vessel revascularisation (TVR).

Main Results:

  • High hsCRP levels (> 3 mg/L) were present in 24.7% of nondiabetics and 29.8% of diabetics, with significantly higher MACE rates in both groups.
  • Elevated hsCRP was associated with increased all-cause mortality in both diabetic (aHR 2.32) and nondiabetic (aHR 3.14) patients.
  • Increased rates of TVR and MI were observed with high hsCRP, primarily in diabetic patients, though no significant interaction with diabetes was found for these outcomes.

Conclusions:

  • High hsCRP levels (> 3 mg/L) are associated with worse ischemic outcomes following PCI, irrespective of diabetes status.
  • hsCRP serves as a valuable prognostic biomarker for predicting MACE in patients undergoing PCI, highlighting the importance of inflammation assessment.
Abstract

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