Document Detail

Preprocedural levels of C-reactive protein and leukocyte counts predict 9-month mortality after coronary angioplasty for the treatment of unprotected left main coronary artery stenosis.
MedLine Citation:
PMID:  16203907     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: An accurate preprocedural risk stratification scheme for patients with unprotected left main coronary artery (ULMCA) stenosis who are undergoing coronary stenting is lacking. We examined the predictive value of preprocedural levels of C-reactive protein (CRP), fibrinogen, and leukocyte counts with respect to 9-month clinical outcomes after stenting of the ULMCA stenosis. METHODS AND RESULTS: Levels of CRP, fibrinogen, and leukocyte count were prospectively measured in 83 patients undergoing stenting of the ULMCA. A drug-eluting stent was used in 42 patients, and a bare metal stent was used in 41. The end point of the study was death and the combination of death and myocardial infarction (MI). By the 9-month follow-up, there were 11 deaths (13%), 7 MIs (8%), and 16 target lesion revascularizations (19%). Death and death/MI occurred in 19% and 31%, respectively, of 59 patients with high serum levels of CRP (>3 mg/L) but in none of 24 patients with normal CRP levels (for death, P=0.02; for death/MI, P=0.006). In multivariate analysis, the highest tertiles of CRP level (P=0.028) and leukocyte count (P=0.002) were the only independent predictors of death. The highest tertiles of CRP level (P=0.002) and leukocyte count (P=0.002) and acute coronary syndromes (P=0.05) were the only independent predictors of the combined end point death/MI. CONCLUSIONS: Elevated preprocedural levels of CRP indicate an increased risk of death and death/MI after ULMCA stenting. Inflammatory risk assessment in patients with ULMCA stenosis may be useful for selecting patients for percutaneous coronary interventions with very low risk.
Tullio Palmerini; Antonio Marzocchi; Cinzia Marrozzini; Paolo Ortolani; Francesco Saia; Letizia Bacchi-Reggiani; Santo Virzì; Silvia Gianstefani; Angelo Branzi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-10-03
Journal Detail:
Title:  Circulation     Volume:  112     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-11     Completed Date:  2006-03-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2332-8     Citation Subset:  AIM; IM    
Istituto di Cardiologia, Policlinico S. Orsola, Università di Bologna, 40 138 Bologna, Italy.
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MeSH Terms
Angioplasty, Balloon / adverse effects*,  mortality
Biological Markers / blood
C-Reactive Protein / metabolism*
Coronary Angiography
Coronary Stenosis / blood*,  mortality,  radiography,  surgery*
Follow-Up Studies
Leukocyte Count*
Middle Aged
Myocardial Revascularization / mortality
Survival Analysis
Time Factors
Reg. No./Substance:
0/Biological Markers; 9007-41-4/C-Reactive Protein
Comment In:
Circulation. 2005 Oct 11;112(15):2226-7   [PMID:  16216973 ]

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