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Prognostic value of high-sensitivity C-reactive protein among chronic kidney disease patients undergoing percutaneous

Davis Jones1, Alessandro Spirito2, Samantha Sartori2

  • 1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Journal of Cardiology
|May 15, 2023
PubMed

Insights

High-sensitivity C-reactive protein (hs-CRP) did not increase major adverse cardiac events (MACE) risk in chronic kidney disease (CKD) patients post-percutaneous coronary intervention (PCI). However, elevated hs-CRP consistently predicted higher mortality in both CKD and non-CKD patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • Limited data exists on the prognostic implications of high-sensitivity C-reactive protein (hs-CRP) in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI).
  • Inflammation, indicated by hs-CRP, is a known factor in cardiovascular disease progression.

Purpose of the Study:

  • To investigate the prognostic value of elevated hs-CRP levels in patients with and without CKD undergoing PCI.
  • To determine the association between hs-CRP and major adverse cardiac events (MACE) and all-cause mortality after PCI.

Main Methods:

  • A retrospective analysis of 12,410 patients undergoing PCI between January 2012 and December 2019.
  • CKD defined as GFR <60 mL/min/1.73m², elevated hs-CRP as >3 mg/L. Excluded were patients with acute MI, acute heart failure, cancer, or on hemodialysis.
  • Primary outcome: MACE (all-cause death, MI, target vessel revascularization) at 1-year post-PCI.

Main Results:

  • Of 12,410 patients, 3029 (24.4%) had CKD. Elevated hs-CRP was more prevalent in CKD patients (31.8%) vs. non-CKD (25.8%).
  • No significant association was found between elevated hs-CRP and MACE at 1-year in CKD (11.0% vs 9.5%) or non-CKD patients (10% vs 8.1%).
  • Elevated hs-CRP was independently associated with increased all-cause mortality in both CKD (adj. HR 1.92) and non-CKD patients (adj. HR 3.02).

Conclusions:

  • Elevated hs-CRP levels were not associated with an increased risk of 1-year MACE in patients undergoing PCI without acute MI.
  • Hs-CRP independently predicted increased all-cause mortality in both CKD and non-CKD patients following PCI.
  • No interaction was observed between hs-CRP and CKD status regarding MACE or mortality outcomes.
Abstract

Keywords:
Chronic kidney diseaseHigh-sensitivity C-reactive proteinPercutaneous coronary intervention

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