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Predictive value of baseline C-reactive protein level in patients with stable coronary artery disease: A
Shuangyan Luo1, Jin Zhang1, Biyan Li1
1Department of Medical Technology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China.
Insights
Elevated C-reactive protein (CRP) levels in patients with stable coronary artery disease (CAD) predict adverse outcomes. This meta-analysis confirms CRP as an independent predictor of major adverse cardiovascular events (MACEs) and mortality.
Area of Science:
- Cardiology
- Biomarkers
- Public Health
Background:
- Conflicting data exists on C-reactive protein (CRP) and adverse outcomes in stable coronary artery disease (CAD).
- Baseline CRP levels require further evaluation for their predictive capacity in stable CAD patients.
Purpose of the Study:
- To conduct a meta-analysis evaluating the predictive value of baseline C-reactive protein (CRP) levels.
- To assess the association of CRP with adverse outcomes in patients with stable coronary artery disease (CAD).
Main Methods:
- Searched PubMed and Embase databases up to November 28, 2021.
- Included 26 studies with 22,602 patients with stable CAD.
- Pooled multivariable adjusted risk ratios for cardiovascular mortality, all-cause mortality, and major adverse cardiovascular events (MACEs) comparing highest to lowest CRP levels.
Main Results:
- Elevated baseline CRP levels significantly predicted adverse outcomes.
- The pooled risk ratio for MACEs was 1.77 (95% CI 1.60-1.96).
- Significant associations were found for cardiovascular mortality (1.64; 95% CI 1.13-2.33) and all-cause mortality (1.62; 95% CI 2.62-5.12).
Conclusions:
- Elevated baseline CRP is an independent predictor of MACEs, cardiovascular mortality, and all-cause mortality in stable CAD.
- Baseline CRP levels offer valuable predictive information for patients with stable CAD.
Background:
Conflicting results have been reported on the association of C-reactive protein (CRP) level with adverse outcomes in patients with stable coronary artery disease (CAD). The objective of this meta-analysis was to evaluate the predictive value of baseline CRP level in stable CAD patients.
Methods:
Two reviewers independently searched PubMed and Embase databases from their inception to November 28, 2021 to identify studies assessing the value of baseline CRP level in predicting adverse outcomes in stable CAD patients. The endpoints of interest included cardiovascular mortality, all-cause mortality, or major adverse cardiovascular events (MACEs). The predictive value of CRP level was estimated by pooling the multivariable adjusted risk ratio with 95% confidence intervals (CI) compared the highest to the lowest CRP level.
Results:
Twenty-six studies involving of 22,602 patients with stable CAD satisfied the inclusion criteria. In a comparison of the highest with the lowest CRP level, the pooled multivariable adjusted risk ratio was 1.77 (95% CI 1.60-1.96) for MACEs, 1.64 (95% CI 1.13-2.33) for cardiovascular mortality, and 1.62 (95% CI 2.62-5.12) for all-cause mortality, respectively. Subgroup analyses indicated that the values of elevated CRP level in predicting MACEs were consistently observed in each subgroup.
Conclusion:
Elevated baseline CRP level was an independent predictor of MACEs, cardiovascular mortality, and all-cause mortality in patients with stable CAD. Baseline CRP level can provide important predictive information in stable CAD patients.
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