Abstract 9356: Pre-procedure C-reactive Protein and Erythrocyte Sedimentation Rate but not Lipoprotein-associated Phospholipase A2 Predict Clinical Outcomes after Drug-eluting Stents Implantation in Patients with Stable Coronary Disease on Chronic Statin Therapy
Background: Pre-procedure high-sensitive C-reactive protein (hs-CRP) level has a prognostic value after PCI. There are few data about the value of other inflammation markers: lipoprotein-associated phospholipase A2 (Lp-PLA2), erythrocyte sedimentation rate (ESR), white blood count (WBC) in predicting periprocedural and long-term outcomes after drug-eluting stent (DES) especially in patients on chronic statin therapy.
Methods: A total of 602 patients (mean age 60.4±9.4 years, 86.0 % males) with stable CAD on chronic statin therapy underwent successful PCI with at least one DES implanted. Baseline demographic, procedural characteristics, Lp-PLA2, hs-CRP, ESR, WBC were collected. Tn I was assessed in all patients 12-18 h after the PCI. Periprocedural MI was defined as measure of the Tn I of more than three times the 99th percentile of the upper reference limit. The patients were prospectively followed before discharge with 1 year of follow-up.
Results: During the in-hospital period major adverse cardiovascular events (MACE) (death, myocardial infarction (MI), stroke, stent thrombosis (ST)) occurred in 10.6% of the patients. Incidence of MACE was essentially due to periprocedural MI (10,3%). Multivariate logistic regression identified ESR level (OR 1.018 95% CI 1.004-1.032, p=0.013) before PCI and total length of stents implanted (OR 1.023, 95% CI 1.008-1.037, p=0.002) as independent predictors of MACE before discharge. At 1 year of follow-up MACE (death, MI, [[Unable to Display Character: с]]linically-driven target lesion revascularization (TLR)) occurred in another 9.3% of the patients. TLR was performed in 5.4% of the patients. Multivariate logistic regression identified baseline hs-CRP (OR 1.7, 95% CI 1.13-2.56, p=0.01) and ESR (OR 2.25, 95% CI 1.21-4.19, p = 0.011) levels, stenting CABG grafts (OR 8.34, 95% CI 1.95-35.6, p = 0.004) as independent predictors of MACE at 1 year. hs-CRP (OR 1.75, 95% CI 1.15-2.67, p = 0.009) and ESR (OR 2.42, 95% CI 1.15-5.13, p = 0.02) levels were independent predictors of TLR at 1 year. WBC and Lp-PLA2 were not predictive of MACE neither acutely nor at 1 year.
Conclusion: Pre-procedure CRP and ESR but not Lp-PLA2 and WBC levels correlate with clinical outcomes including TLR in patients with stable CAD on chronic statin therapy undergoing DES implantation.
- © 2012 by American Heart Association, Inc.