Post-PCI Risk Assessment by Inflammation Activity According to Disease Acuity and Time from Procedure

传统PCI 医学 内科学 心肌梗塞 心脏病学 疾病 血栓形成 外科 炎症
作者
Hae‐Geun Song,Jong‐Hwa Ahn,Min Gyu Kang,Kyehwan Kim,Jae Seok Bae,Sang Young Cho,Jin-Sin Koh,Yongwhi Park,Seok‐Jae Hwang,Eun Jeong Cho,Kyeongmin Byeon,Sang‐Wook Kim,Udaya S. Tantry,Paul A. Gurbel,Jin‐Yong Hwang,Young‐Hoon Jeong
出处
期刊:Thrombosis and Haemostasis [Thieme Medical Publishers (Germany)]
卷期号:123 (06): 627-640 被引量:1
标识
DOI:10.1055/a-2011-8426
摘要

Background High-sensitivity C-reactive protein (hs-CRP) has been proposed as an indicator of inflammation and cardiovascular risk. However, little is known of the comparative temporal profile of hs-CRP and its relation to outcomes according to the disease acuity. Methods We enrolled 4,263 East Asian patients who underwent percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) and stable disease. hs-CRP was measured at baseline and 1 month post-PCI. Major adverse cardiovascular events (MACE: the composite occurrence of death, myocardial infarction, or stroke) and major bleeding were followed up to 4 years. Result The AMI group (n = 2,376; 55.7%) had higher hs-CRPbaseline than the non-AMI group (n = 1,887; 44.3%) (median: 1.5 vs. 1.0 mg/L; p < 0.001), which remained higher at 1 month post-PCI (median: 1.0 vs. 0.9 mg/L; p = 0.001). During 1 month, a high inflammatory-risk phenotype (upper tertile: hs-CRPbaseline ≥ 2.4 mg/L) was associated with a greater MACE in the AMI group (adjusted hazard ratio [HRadj]: 7.66; 95% confidence interval [CI]: 2.29–25.59; p < 0.001), but not in the non-AMI group (HRadj: 0.74; 95% CI: 0.12–4.40; p = 0.736). Between 1 month and 4 years, a high inflammatory-risk phenotype (upper tertile: hs-CRP1 month ≥ 1.6 mg/L) was associated with greater MACE compared to the other phenotype in both the AMI (HRadj: 2.40; 95% CI: 1.73–3.45; p < 0.001) and non-AMI groups (HRadj: 2.67; 95% CI: 1.80–3.94; p < 0.001). Conclusion AMI patients have greater inflammation during the early and late phases than non-AMI patients. Risk phenotype of hs-CRPbaseline correlates with 1-month outcomes only in AMI patients. However, the prognostic implications of this risk phenotype appears similar during the late phase, irrespective of the disease acuity.
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