Abstract 3521: Prognostic Impact of Preprocedural C-Reactive Protein Levels on Six-Month Angiographic and One-Year Clinical Outcomes After Drug-Eluting Stent Implantation
Background: Although preprocedural levels of C-reactive protein (CRP) have been proposed as a useful marker for identifying patients at high risk of adverse coronary events and restenosis after coronary intervention, the prognostic value of preprocedural CRP for risk prediction in patients undergoing drug-eluting stent (DES) implantation remains largely unknown.
Methods: We prospectively evaluated the association of preprocedural CRP with angiographic restenosis and adverse clinical events in 1,650 consecutive patients receiving DES implantation. Patients were grouped into tertiles according to CRP values for analysis. 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%) of the middle tertile and in 16 (2.9%) of the highest tertile (p=0.003). In multivariate analysis, tertiles of CRP levels were independent predictors of a major coronary event (HR 4.68, 95% CI 1.91–11.44, 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 were significantly associated with major coronary events after DES implantation. However preprocedural CRP levels do not predict subsequent restenosis.