TY - JOUR
T1 - Effect of Elevated C-Reactive Protein on Outcomes After Complex Percutaneous Coronary Intervention for Angina Pectoris
AU - Camaj, Anton
AU - Giustino, Gennaro
AU - Kocovic, Nikola
AU - Cao, Davide
AU - Claessen, Bimmer E.
AU - Sartori, Samantha
AU - Zhang, Zhongjie
AU - Qiu, Hanbo
AU - Nicolas, Johny
AU - Hinohara, Tomoya
AU - Baber, Usman
AU - Power, David A.
AU - Barman, Nitin
AU - Sweeny, Joseph
AU - Dangas, George
AU - Kini, Annapoorna
AU - Sharma, Samin K.
AU - Mehran, Roxana
N1 - Funding Information: Dr. Dangas has received consulting fees from Boston Scientific; has served as a consultant for Sanofi, AstraZeneca, and Abbott Vascular; and has served as an Advisory Board member for Abbott Vascular and Boston Scientific. Dr. Baber has received speaking honoraria from AstraZeneca and Boston Scientific. Dr. Sharma has performed industry-sponsored lectures for Abbott Laboratories, AngioScore, Inc., Boston Scientific Corporation, Cardiovascular Systems, Inc., Daiichi-Sankyo Co., Ltd./Eli Lilly and Company Partnership, Medtronic, Inc., and the Medicines Company; has served on the Scientific Advisory Board for Cardiovascular Systems, Inc.; and has served on the Speakers Bureau for Abbott Vascular, Boston Scientific, and Cardiovascular Systems, Inc. Dr. Mehran has received institutional research grant support from Eli Lilly/Daiichi-Sankyo, Bristol-Myers Squibb, AstraZeneca, The Medicines Company, OrbusNeich, Bayer, CSL Behring, Abbott Laboratories, Watermark Research Partners, Novartis Pharmaceuticals, Medtronic, AUM Cardiovascular, and Beth Israel Deaconess Medical Center; is a member of the executive committees for Janssen Pharmaceuticals, Bristol-Myers Squibb, and Osprey Medical; is a member of the data safety monitoring board of Watermark Research Partners; has received institutional (payment to institution) Advisory Board funding from Bristol-Myers Squibb and Novartis; has served as a consultant for Medscape, The Medicines Company, Boston Scientific, Merck & Company Cardiovascular Systems, Sanofi USA, Shanghai BraccoSine Pharmaceutical, and AstraZeneca; and holds equity in Claret Medical and Elixir Medical Corporation. Dr. Giustino has received speaking honoraria from Bristol-Myers Squibb and Pfizer. The remaining authors have no conflicts of interest to declare. Publisher Copyright: © 2021 Elsevier Inc.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Inflammation and procedural complexity are individually associated with adverse outcomes after percutaneous coronary intervention (PCI). We aimed to evaluate the association of high sensitivity C-reactive protein (hsCRP) with adverse events according to PCI complexity. We included patients with available hsCRP levels who underwent PCI at our center from 2012 to 2017. We compared patients with hsCRP ≥3 versus <3 mg/L. Complex PCI was defined as having ≥1 of the following: ≥3 different target vessels, ≥3 lesions treated, ≥3 stents implanted, bifurcation lesion treated with 2 stents, chronic total occlusion as target lesion, or total stent length >60 mm. The primary end point was major adverse cardiac events (MACEs) (composite of all-cause death, myocardial infarction, or target vessel revascularization) at 1 year. A total of 11,979 patients were included, of which 2,840 (24%) underwent complex PCI. In those, 767 (27%) had hsCRP ≥3 mg/L. The 1-year incidence of MACE was 6% (noncomplex PCI, low hsCRP), 10% (noncomplex PCI, high hsCRP), 10% (complex PCI, low hsCRP), and 15% (complex PCI, high hsCRP). Overall, hsCRP ≥3 mg/L was associated with an increased risk of MACE compared with hsCRP <3 mg/L; this was independent of the number of complex PCI features: 0 (adjusted hazard ratio [HR] 1.53; 95% confidence interval [CI] 1.27 to 1.86), 1 (adjusted HR 1.77; 95% CI 1.21 to 2.60), or ≥2 (adjusted HR 1.21; 95% CI 0.80 to 1.83) (pinteraction = 0.42). In conclusion, in patients who underwent PCI, elevated hsCRP is associated with an increased risk of ischemic events. The effect of elevated hsCRP on cardiovascular risk is consistent regardless of PCI complexity.
AB - Inflammation and procedural complexity are individually associated with adverse outcomes after percutaneous coronary intervention (PCI). We aimed to evaluate the association of high sensitivity C-reactive protein (hsCRP) with adverse events according to PCI complexity. We included patients with available hsCRP levels who underwent PCI at our center from 2012 to 2017. We compared patients with hsCRP ≥3 versus <3 mg/L. Complex PCI was defined as having ≥1 of the following: ≥3 different target vessels, ≥3 lesions treated, ≥3 stents implanted, bifurcation lesion treated with 2 stents, chronic total occlusion as target lesion, or total stent length >60 mm. The primary end point was major adverse cardiac events (MACEs) (composite of all-cause death, myocardial infarction, or target vessel revascularization) at 1 year. A total of 11,979 patients were included, of which 2,840 (24%) underwent complex PCI. In those, 767 (27%) had hsCRP ≥3 mg/L. The 1-year incidence of MACE was 6% (noncomplex PCI, low hsCRP), 10% (noncomplex PCI, high hsCRP), 10% (complex PCI, low hsCRP), and 15% (complex PCI, high hsCRP). Overall, hsCRP ≥3 mg/L was associated with an increased risk of MACE compared with hsCRP <3 mg/L; this was independent of the number of complex PCI features: 0 (adjusted hazard ratio [HR] 1.53; 95% confidence interval [CI] 1.27 to 1.86), 1 (adjusted HR 1.77; 95% CI 1.21 to 2.60), or ≥2 (adjusted HR 1.21; 95% CI 0.80 to 1.83) (pinteraction = 0.42). In conclusion, in patients who underwent PCI, elevated hsCRP is associated with an increased risk of ischemic events. The effect of elevated hsCRP on cardiovascular risk is consistent regardless of PCI complexity.
UR - http://www.scopus.com/inward/record.url?scp=85123023728&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.amjcard.2021.12.042
DO - https://doi.org/10.1016/j.amjcard.2021.12.042
M3 - Article
C2 - 35058052
SN - 0002-9149
VL - 168
SP - 47
EP - 54
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -