Abstract 8994: Elevated C-Reactive Protein Levels Predict Prognosis and Interact With Diabetes and Hypertension in the Development of Coronary Spasm
Introduction: The prognostic significance of high-sensitivity C-reactive protein (hs-CRP) in patients with coronary spasm and its association with diabetes and hypertension on the risk of coronary spasm remain unexplored. Hypothesis: We assessed the hypothesis that elevated hs-CRP level predicts outcomes in patients with coronary spasm and interacts with diabetes and hypertension in coronary spasm development.
Methods: Patients undergoing coronary angiography with proven coronary spasm but without coronary stenosis >50% were evaluated. A total of 897 subjects, including 350 women and 547 men, were analyzed and followed up for a median of 5.8 years. The levels of hs-CRP measured before coronary angiography were examined in a subset of 555 patients.
Results: In women, only the highest hs-CRP tertile (>3 mg/L) was independently associated with coronary spasm. In men, age, smoking and the highest hs-CRP tertile were independently associated with coronary spasm. Patients with the highest hs-CRP tertile had more coronary events compared with those without (p = 0.021, log-rank test). The highest hs-CRP tertile was a significant independent predictor of poor prognosis. The odds ratios of coronary spasm in both women and men with hs-CRP in the highest tertile reduced from 4.41 (95% confidence interval [CI]=1.77-10.97, p=0.001) to 1.45 and 2.86 (CI=1.47-5.57, p=0.002) to 1.59, respectively, if they had diabetes, and from 9.68 (CI=2.63-35.68, p=0.001) to 2.43 and 2.67 (CI=1.17-6.08, p=0.019) to 1.68, respectively, if they had hypertension.
Conclusions: Elevated hs-CRP level predicts adverse outcome in coronary spasm patients. The negative effects of diabetes and hypertension on coronary spasm suggest that the pathogenesis of coronary spasm differs from that of coronary atherosclerosis.
- © 2012 by American Heart Association, Inc.