Document Detail


Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation.
MedLine Citation:
PMID:  17309906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the association of preprocedural C reactive protein (CRP) levels with angiographic restenosis and adverse clinical events after drug-eluting stent (DES) implantation.
DESIGN: A prospective cohort analysis of preprocedural CRP levels as a predictor of serious ischaemic complications or binary restenosis in patients treated with DES.
SETTING: Tertiary referral centre.
PATIENTS: 1650 consecutive patients who underwent successful DES implantation. Patients were grouped into tertiles according to preprocedural CRP values for data analysis.
INTERVENTIONS: Successful DES implantation.
MAIN OUTCOME MEASURES: The primary end point was a major coronary event, defined as cardiac death or Q-wave myocardial infarction.
RESULTS: Baseline clinical and angiographic characteristics were similar between the tertile groups, except that more patients had multivessel disease and acute coronary syndrome with increasing tertiles of CRP levels. At 1-year follow-up, a primary end point occurred in 4 (0.7%) patients of the lowest tertile, in 3 (0.5%) patients of the middle tertile and in 16 (2.9%) patients of the highest tertile (p = 0.003). In multivariate analysis, the highest tertile of CRP levels was an independent predictor of a major coronary event (HR 4.68, 95% CI 1.91 to 11.44, tertile III vs tertiles I and II, p = 0.001). However, restenosis rates were similar in all three groups (9.1% vs 11.4% vs 11.6%, respectively, p = 0.3).
CONCLUSIONS: Preprocedural CRP levels are significantly associated with major coronary events after DES implantation. However, preprocedural CRP levels do not predict subsequent restenosis. Baseline CRP levels may be useful to guide adjunctive management for preventing serious ischaemic events in patients undergoing DES implantation.
Authors:
Duk-Woo Park; Cheol Whan Lee; Sung-Cheol Yun; Young-Hak Kim; Myeong-Ki Hong; Jae-Joong Kim; Seong-Wook Park; Seung-Jung Park
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-02-19
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  93     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-10-04     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1087-92     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Epidemiology, University of Ulsan College of Medicine, Asan Medical Center, Poongnap-dong, Songpa-gu, Seoul, South Korea. sjpark@amc.seoul.kr
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary
Biological Markers / blood
C-Reactive Protein / analysis*
Coronary Angiography
Coronary Disease / blood*,  radiography,  therapy*
Coronary Restenosis / blood,  radiography
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Myocardial Infarction / blood
Paclitaxel / administration & dosage
Prognosis
Stents*
Chemical
Reg. No./Substance:
0/Biological Markers; 33069-62-4/Paclitaxel; 9007-41-4/C-Reactive Protein
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