Document Detail

Association between C-reactive protein and angiographic restenosis after bare metal stents: an updated and comprehensive meta-analysis of 2747 patients.
MedLine Citation:
PMID:  18606379     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Previous studies have shown conflicting results about the relationship between baseline C-reactive protein (CRP) and restenosis after stenting with bare metal stent (BMS). METHODS: We assessed the association between serum CRP and angiographic restenosis after BMS by meta-analysis. Studies that reported basal serum CRP levels, above a prespecified cutoff value, before BMS deployment were included. An inverse random weighted meta-analysis was performed by entering the logarithm of the odds ratio (OR) of angiographic restenosis with its standard error for each study. RESULTS: Nine studies enrolling 2747 patients were selected. CRP threshold value was around 3 mg/l in three studies, 5 mg/l in four studies, and 6.98 and 10 mg/l in one study. Follow-up duration was 6.2+/-3.0 (mean+/-S.D.) months. Higher preprocedural CRP levels were a significant predictor of angiographic restenosis: OR 1.59, 95% confidence interval 1.21-2.07, P=.001. Heterogeneity was found: chi2 14.47, P=.07; I2=44.7%. Publication bias was also detected (P=.01, Egger's test). A sensitivity analysis, after excluding each study in turn, confirmed the predictive value of higher CRP levels, in agreement with the results of the main analysis. CONCLUSIONS: Among patients with coronary artery disease, undergoing percutaneous coronary intervention with BMS, higher baseline CRP levels are associated with higher risk of angiographic restenosis. A targeted therapeutic approach to patients with high baseline CRP, based on statins, oral corticosteroids, or PPAR gamma agonists, or selective use of drug-eluting stents, aiming at abating the higher risk of in-stent restenosis should be considered.
Giuseppe Ferrante; Giampaolo Niccoli; Luigi M Biasucci; Giovanna Liuzzo; Francesco Burzotta; Leonarda Galiuto; Carlo Trani; Antonio G Rebuzzi; Filippo Crea
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Cardiovascular revascularization medicine : including molecular interventions     Volume:  9     ISSN:  1553-8389     ISO Abbreviation:  -     Publication Date:    2008 Jul-Sep
Date Detail:
Created Date:  2008-07-08     Completed Date:  2008-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101238551     Medline TA:  Cardiovasc Revasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  156-65     Citation Subset:  IM    
Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
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MeSH Terms
Anticholesteremic Agents / therapeutic use
C-Reactive Protein / metabolism*
Coronary Angiography / methods*
Coronary Restenosis / blood*,  radiography
Predictive Value of Tests
Prosthesis Failure
Reg. No./Substance:
0/Anticholesteremic Agents; 9007-41-4/C-Reactive Protein

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