Abstract 15088: Multiple Biomarker Panels for Risk Assessment of Cardiocerebrovascular Events and Mortality after Elective Percutaneous Coronary Intervention with Drug-Eluting Stents
Background: Numerous biomarkers have been introduced to improve risk stratification for cardiovascular diseases. The purpose of this study is to assess the hypothesis that multiple biomarker panels, including high-sensitivity C-reactive protein (hsCRP) for inflammation, N-terminal pro-brain natriuretic peptide (NTproBNP) for ventricular dysfunction, cystatin C (CysC) for chronic kidney disease, remnant cholesterol (RemL-C) for remnant metabolism, and eicosapentaenoic acid/arachidonic acid (EPA/AA) for dietary habits, could help guide risk stratification in patients after elective percutaneous coronary intervention (PCI) with drug-eluting stents.
Methods: We enrolled 449 consecutive patients undergoing elective PCI with sirolimus-eluting stent (SES). Serum levels of hsCRP, NTproBNP, CysC, RemL-C, and EPA/AA, were measured before SES implantation. We assessed the relations between each biomarker, combination of these biomarkers, mortality, and major adverse cardiocerebrovascular events (MACCE: death, acute coronary syndrome, stroke, and admission for heart failure).
Results: After a median follow-up of 71 months, 30 patients died, and 88 patients developed MACCE. The levels of hsCRP, NTproBNP, and CysC were significantly higher and EPA/AA was lower in patients who died than in survivors. Cut-off points were defined according to previous literature or the ROC curves as follows: hsCRP>3mg/L, NTproBNP>386ng/L, CysC>1.29mg/L, RemL-C>7.5mg/dl, and EPA/AA<0.53. A multivariate Cox regression model after adjustment of established risk factors, hsCRP (HR 3.2), NTproBNP (HR 3.7), cystatin C (HR 6.8), and EPA/AA (HR 6.6) except RemL-C, significantly predicted the risks of mortality. In comparison to patients who were all-negative for the significant four biomarkers, patients with 3 or 4 positives had elevated risks of mortality (HR 30.2, P<0.0003). Same trends were observed in patients who developed MACCE.
Conclusions: These data demonstrated that multiple biomarker panels, including hsCRP, NTproBNP, CysC, and EPA/AA, may be useful for assess the risk stratification of mortality and cardiovascular events in patients after elective SES implantation.
- © 2011 by American Heart Association, Inc.