Document Detail


Predictive value of coronary artery stenoses and C-reactive protein levels in patients with stable coronary artery disease.
MedLine Citation:
PMID:  18823889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION AND AIMS: Coronary occlusions resulting in acute events often occur at the site of non-severe stenoses. We sought to assess the prognostic value of non-obstructive coronary stenoses and C-reactive protein (CRP) levels in patients with chronic stable angina (CSA). METHODS: We studied 790 consecutive patients with CSA who underwent routine coronary arteriography. High sensitivity CRP and coronary angiograms were assessed at study entry. Angiographic coronary disease severity was graded using a "vessel score" (number of coronary arteries showing at least 50% reduction in lumen diameter) and extent of disease with an "extension score" (proportion of the coronary artery tree showing angiographically detectable atheroma). Patients were followed up for 1 year. RESULTS: Significant left main stem disease was present in 54 patients (6.8%). 368 patients (46.6%) underwent revascularization. 71 patients (9%) had at least one of the events comprised in the combined study end-point (unstable angina, myocardial infarction (AMI) and cardiac death). Patients who suffered cardiac adverse events had a significantly higher vessel score (n) (2.0 [2.0-3.0] vs. 2.0 [1.0-2.0], P<0.001), extension score (%) (23.5 [17-34.5] vs. 16.0 [6.0-27.0], P<0.001) and CRP levels (mg/L) (3.0 [1.8-7.2] vs. 2.3 [1.1-4.7], P=0.001) compared to patients without events. Age, previous history of AMI, vessel score, extension score and CRP levels were significantly associated with the study end-point. Multivariate analysis showed extension score (OR 5.3 [2.8-10.3] CI 95%; P<0.001), revascularization (OR 0.26 [0.14-0.48] CI 95%; P<0.001) and CRP levels (OR 1.9 [1.1-3.2] CI 95%; P=0.03), but not vessel score (P=0.1), to be independent predictors of the combined end-point. CONCLUSIONS: In patients with CSA, independently of revascularization, extension score and CRP levels predict cardiac adverse events, regardless of the presence or absence of flow limiting coronary lesions.
Authors:
Ramón Arroyo-Espliguero; Pablo Avanzas; Juan Quiles; Juan Carlos Kaski
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Publication Detail:
Type:  Journal Article     Date:  2008-08-15
Journal Detail:
Title:  Atherosclerosis     Volume:  204     ISSN:  1879-1484     ISO Abbreviation:  Atherosclerosis     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-04     Completed Date:  2009-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  239-43     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Hospital General Universitario, Guadalajara, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / etiology*,  immunology,  mortality,  pathology,  therapy
Biological Markers / blood
C-Reactive Protein / analysis*
Chronic Disease
Coronary Angiography*
Coronary Stenosis / complications,  mortality,  radiography*,  therapy
Female
Humans
Inflammation / complications,  immunology*,  mortality,  therapy
Male
Middle Aged
Myocardial Infarction / etiology*,  immunology,  mortality,  pathology,  therapy
Myocardial Revascularization
Odds Ratio
Predictive Value of Tests
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Up-Regulation
Chemical
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein

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