Abstract 12871: High Sensitivity C-Reactive Protein is Associated with Coronary Plaque Burden as Measured by Intravascular Ultrasound and Adverse Cardiovascular Outcome
Background: High sensitivity C-reactive protein (hsCRP) is a prognostic marker in coronary artery disease (CAD). However, its relation with coronary plaque characteristics is not yet investigated. We studied the association between hsCRP, coronary plaque characteristics as measured in-vivo by intravascular ultrasound (IVUS) and 1-year cardiovascular outcome in CAD patients.
Methods: In the ATHEROREMO-IVUS study, IVUS imaging of a non-culprit coronary artery was performed in 581 patients who underwent coronary angiography for acute coronary syndrome (ACS) or stable angina pectoris between 2008 and 2011. Primary endpoint was 1-year major adverse cardiac events (MACE), defined as all-cause mortality, non-fatal ACS or unplanned coronary revascularization. Definite culprit lesion related MACE were not counted.
Results: Baseline hsCRP levels were associated with higher coronary plaque burden in the imaged coronary segment (p=0.013) (Figure) and tended to be associated with presence of large lesions (plaque burden of ≥70%; p=0.093), but not with presence of IVUS-classified thin-cap fibroatheroma lesions (p=0.36) or lesions with minimal luminal area ≤4.0 mm2 (p=0.62). After adjustment for established cardiac risk factors, elevated hsCRP levels were independently associated with MACE at 1-year (HR per SD increase in ln-transformed hsCRP 1.44, 95%CI 1.07-1.96, p=0.018), as well as with the composite of all-cause mortality and non-fatal ACS only (HR 2.05, 95%CI 1.40-3.00, p≤0.001) (Figure).
Conclusion: In patients undergoing coronary angiography, elevated hsCRP levels are associated with higher coronary plaque burden and are predictive for adverse cardiovascular outcome at 1 year.
- © 2013 by American Heart Association, Inc.