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High CRP predicts long-term mortality, MI after PCI
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Higher levels of C-reactive protein at the time of PCI were predictive of all-cause mortality and MI at 10 years, researchers reported in a new study.
Researchers studied 468 patients who underwent PCI with a sirolimus-eluting stent for stable CAD or ACS in 2002.
Forty-three percent of patients had high-sensitivity C-reactive protein (CRP) greater than 3 mg/L, 31% had levels of 1 mg/L to 3 mg/L and 14.7% had levels less than 1 mg/L.
Compared with the lowest CRP levels, patients with CRP greater than 3 mg/L had a higher incidence of all-cause mortality and MI at 10 years (HR = 2.87; 95% CI, 1.69-4.87), after adjustment for CV risk factors and clinical presentation. Patients with CRP levels of 1 mg/L to 3 mg/L also had an increased incidence of CV outcomes compared with patients with the lowest levels (HR = 2.3; 95% CI, 1.31-4.03).
Further analysis indicated that the association between CRP and all-cause mortality and MI was similar both in patients with ACS (high vs. low levels: HR = 3.64; 95% CI, 1.74-7.61) and stable angina (high vs. low levels: HR = 3.18; 95% CI, 1.54-6.57).
When the researchers added CRP levels to a prediction model that included traditional CV risk factors, they did not observe a significant improvement in discriminatory power (area under the receiver operating curve, 0.71-0.73; P = .56). However, the addition of CRP to the prediction model resulted in improved classification of risk (net classification index, 0.4; P < .001).
The researchers concluded that high-sensitivity CRP “may be a useful biomarker for long-term risk assessment in patients with established CAD and undergoing PCI.” – by Rob Volansky
Disclosure: The researchers report no relevant financial disclosures.
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