| Relation of C-reactive protein level and long-term risk of death or myocardial infarction following percutaneous coronary intervention with a sirolimus-eluting stent. | |
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MedLine Citation:
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PMID: 16923447 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Previous observations in the bare metal stent (BMS) era have demonstrated an association between a high preprocedural C-reactive protein (CRP) level and an increased incidence of death or myocardial infarction after percutaneous coronary intervention (PCI). We hypothesized that PCI with sirolimus-eluting stents (SESs) would result in a smaller increase in CRP compared with BMSs and that a high CRP level before PCI would be associated with a higher incidence of death or myocardial infarction at 12 months, regardless of the type of stent implanted. We analyzed patients who underwent PCI with stenting at the Cleveland Clinic Foundation. Patients who received BMSs and SESs were analyzed separately by categorizing them into low and high CRP groups based on whether their CRP level before PCI was above or below the median for each group. The increase in CRP that occurred with PCI was termed DeltaCRP. In total, 652 patients were included in the analysis. Median DeltaCRP was smaller in the SES group than in the BMS group (1.5 vs 0.7 mg/L, p = 0.009). In the BMS group, patients with a CRP level above the median before PCI had a higher incidence of 12-month death or myocardial infarction compared with patients with a CRP level below the median (11.3% vs 1.6%, p = 0.002). The same relation was present in the SES group, i.e., patients with a higher CRP level had a higher incidence of 12-month death or myocardial infarction compared with patients with a low CRP level (6.3% vs 1.0%, p = 0.005) and a higher 12-month mortality (5.2% vs 0%, p = 0.001). Multivariate logistic regression analysis demonstrated that the CRP level above the median before PCI was associated with a higher 12-month incidence of death or myocardial infarction, independent of the type of stent used, or DeltaCRP. In conclusion, PCI in the SES era causes a smaller increase in CRP compared with the BMS era. A high CRP level before PCI is independently associated with a higher risk of long-term death or myocardial infarction. This finding was present in the BMS and SES groups and highlights the need for aggressive risk-factor modification after PCI. |
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Authors:
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Juhana Karha; Anthony A Bavry; Vivek Rajagopal; Mark R Henderson; Stephen G Ellis; Sorin J Brener |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2006-07-10 |
Journal Detail:
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Title: The American journal of cardiology Volume: 98 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2006 Sep |
Date Detail:
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Created Date: 2006-08-22 Completed Date: 2006-09-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 616-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Biological Markers / blood Blood Vessel Prosthesis Implantation / instrumentation* C-Reactive Protein / metabolism* Coated Materials, Biocompatible* Coronary Disease* / blood, mortality, surgery Female Follow-Up Studies Humans Immunosuppressive Agents / therapeutic use Incidence Male Middle Aged Myocardial Infarction* / blood, epidemiology Ohio / epidemiology Prognosis Prospective Studies Risk Factors Sirolimus / therapeutic use* Stents* Survival Rate / trends Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Coated Materials, Biocompatible; 0/Immunosuppressive Agents; 53123-88-9/Sirolimus; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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