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Post-PCI Risk Assessment by Inflammation Activity According to Disease Acuity and Time from Procedure

Haegeun Song1,2, Jong-Hwa Ahn3, Min Gyu Kang4,5

  • 1Division of Cardiology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea.

Thrombosis and Haemostasis
|January 12, 2023
PubMed

Insights

Acute myocardial infarction (AMI) patients show higher inflammation than non-AMI patients. Early high-sensitivity C-reactive protein (hs-CRP) predicts outcomes in AMI, while later hs-CRP predicts outcomes in both AMI and non-AMI patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Inflammation Research

Background:

  • High-sensitivity C-reactive protein (hs-CRP) is a marker for inflammation and cardiovascular disease risk.
  • Limited data exists on the temporal profile of hs-CRP and its association with outcomes based on disease acuity.

Purpose of the Study:

  • To investigate the temporal profile of hs-CRP in patients undergoing percutaneous coronary intervention (PCI).
  • To evaluate the relationship between hs-CRP levels and major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) versus stable coronary artery disease.

Main Methods:

  • A cohort of 4,263 East Asian patients undergoing PCI for AMI or stable disease was studied.
  • hs-CRP levels were measured at baseline and 1 month post-PCI.
  • Patients were followed for up to 4 years for MACE (death, myocardial infarction, stroke) and major bleeding.

Main Results:

  • AMI patients exhibited higher baseline and 1-month post-PCI hs-CRP levels compared to non-AMI patients (p < 0.001).
  • Elevated baseline hs-CRP (≥ 2.4 mg/L) predicted higher MACE within 1 month only in the AMI group (aHR: 7.66).
  • Elevated 1-month hs-CRP (≥ 1.6 mg/L) predicted higher MACE between 1 month and 4 years in both AMI (aHR: 2.40) and non-AMI groups (aHR: 2.67).

Conclusions:

  • Patients with AMI experience heightened inflammation in both early and late post-PCI phases compared to non-AMI patients.
  • Baseline hs-CRP is a significant predictor of short-term outcomes exclusively in AMI patients.
  • The prognostic value of hs-CRP for long-term outcomes is comparable between AMI and non-AMI patients.
Abstract

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