Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation

Duk Woo Park, Whan Lee Cheol, Sung Cheol Yun, Young Hak Kim, Myeongki Hong, Jae Joong Kim, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Objective: To determine the association of preprocedural C reactive protein (CRP) levels with angiographic restenosis and adverse clinical events after drug-eluting stent (DES) implantation. Design: A prospective cohort analysis of preprocedural CRP levels as a predictor of serious ischaemic complications or binary restenosis in patients treated with DES. Setting: Tertiary referral centre. Patients: 1650 consecutive patients who underwent successful DES implantation. Patients were grouped into tertiles according to preprocedural CRP values for data analysis. Interventions: Successful DES implantation. Main outcome measures: The primary end point was a major coronary event, defined as cardiac death or Q-wave myocardial infarction. Results: Baseline clinical and angiographic characteristics were similar between the tertile groups, except that more patients had multivessel disease and acute coronary syndrome with increasing tertiles of CRP levels. At 1-year follow-up, a primary end point occurred in 4 (0.7%) patients of the lowest tertile, in 3 (0.5%) patients of the middle tertile and in 16 (2.9%) patients of the highest tertile (p = 0.003). In multivariate analysis, the highest tertile of CRP levels was an independent predictor of a major coronary event (HR 4.68, 95% CI 1.91 to 11.44, tertile III vs tertiles I and II, p = 0.001). However, restenosis rates were similar in all three groups (9.1% vs 11.4% vs 11.6%, respectively, p = 0.3). Conclusions: Preprocedural CRP levels are significantly associated with major coronary events after DES implantation. However, preprocedural CRP levels do not predict subsequent restenosis. Baseline CRP levels may be useful to guide adjunctive management for preventing serious ischaemic events in patients undergoing DES implantation.

Original languageEnglish
Pages (from-to)1087-1092
Number of pages6
JournalHeart
Volume93
Issue number9
DOIs
Publication statusPublished - 2007 Sep 1

Fingerprint

Drug-Eluting Stents
C-Reactive Protein
Acute Coronary Syndrome
Tertiary Care Centers
Cohort Studies
Multivariate Analysis
Myocardial Infarction
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Duk Woo ; Cheol, Whan Lee ; Yun, Sung Cheol ; Kim, Young Hak ; Hong, Myeongki ; Kim, Jae Joong ; Park, Seong Wook ; Park, Seung Jung. / Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation. In: Heart. 2007 ; Vol. 93, No. 9. pp. 1087-1092.
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title = "Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation",
abstract = "Objective: To determine the association of preprocedural C reactive protein (CRP) levels with angiographic restenosis and adverse clinical events after drug-eluting stent (DES) implantation. Design: A prospective cohort analysis of preprocedural CRP levels as a predictor of serious ischaemic complications or binary restenosis in patients treated with DES. Setting: Tertiary referral centre. Patients: 1650 consecutive patients who underwent successful DES implantation. Patients were grouped into tertiles according to preprocedural CRP values for data analysis. Interventions: Successful DES implantation. Main outcome measures: The primary end point was a major coronary event, defined as cardiac death or Q-wave myocardial infarction. Results: Baseline clinical and angiographic characteristics were similar between the tertile groups, except that more patients had multivessel disease and acute coronary syndrome with increasing tertiles of CRP levels. At 1-year follow-up, a primary end point occurred in 4 (0.7{\%}) patients of the lowest tertile, in 3 (0.5{\%}) patients of the middle tertile and in 16 (2.9{\%}) patients of the highest tertile (p = 0.003). In multivariate analysis, the highest tertile of CRP levels was an independent predictor of a major coronary event (HR 4.68, 95{\%} CI 1.91 to 11.44, tertile III vs tertiles I and II, p = 0.001). However, restenosis rates were similar in all three groups (9.1{\%} vs 11.4{\%} vs 11.6{\%}, respectively, p = 0.3). Conclusions: Preprocedural CRP levels are significantly associated with major coronary events after DES implantation. However, preprocedural CRP levels do not predict subsequent restenosis. Baseline CRP levels may be useful to guide adjunctive management for preventing serious ischaemic events in patients undergoing DES implantation.",
author = "Park, {Duk Woo} and Cheol, {Whan Lee} and Yun, {Sung Cheol} and Kim, {Young Hak} and Myeongki Hong and Kim, {Jae Joong} and Park, {Seong Wook} and Park, {Seung Jung}",
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Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation. / Park, Duk Woo; Cheol, Whan Lee; Yun, Sung Cheol; Kim, Young Hak; Hong, Myeongki; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung.

In: Heart, Vol. 93, No. 9, 01.09.2007, p. 1087-1092.

Research output: Contribution to journalArticle

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T1 - Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation

AU - Park, Duk Woo

AU - Cheol, Whan Lee

AU - Yun, Sung Cheol

AU - Kim, Young Hak

AU - Hong, Myeongki

AU - Kim, Jae Joong

AU - Park, Seong Wook

AU - Park, Seung Jung

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N2 - Objective: To determine the association of preprocedural C reactive protein (CRP) levels with angiographic restenosis and adverse clinical events after drug-eluting stent (DES) implantation. Design: A prospective cohort analysis of preprocedural CRP levels as a predictor of serious ischaemic complications or binary restenosis in patients treated with DES. Setting: Tertiary referral centre. Patients: 1650 consecutive patients who underwent successful DES implantation. Patients were grouped into tertiles according to preprocedural CRP values for data analysis. Interventions: Successful DES implantation. Main outcome measures: The primary end point was a major coronary event, defined as cardiac death or Q-wave myocardial infarction. Results: Baseline clinical and angiographic characteristics were similar between the tertile groups, except that more patients had multivessel disease and acute coronary syndrome with increasing tertiles of CRP levels. At 1-year follow-up, a primary end point occurred in 4 (0.7%) patients of the lowest tertile, in 3 (0.5%) patients of the middle tertile and in 16 (2.9%) patients of the highest tertile (p = 0.003). In multivariate analysis, the highest tertile of CRP levels was an independent predictor of a major coronary event (HR 4.68, 95% CI 1.91 to 11.44, tertile III vs tertiles I and II, p = 0.001). However, restenosis rates were similar in all three groups (9.1% vs 11.4% vs 11.6%, respectively, p = 0.3). Conclusions: Preprocedural CRP levels are significantly associated with major coronary events after DES implantation. However, preprocedural CRP levels do not predict subsequent restenosis. Baseline CRP levels may be useful to guide adjunctive management for preventing serious ischaemic events in patients undergoing DES implantation.

AB - Objective: To determine the association of preprocedural C reactive protein (CRP) levels with angiographic restenosis and adverse clinical events after drug-eluting stent (DES) implantation. Design: A prospective cohort analysis of preprocedural CRP levels as a predictor of serious ischaemic complications or binary restenosis in patients treated with DES. Setting: Tertiary referral centre. Patients: 1650 consecutive patients who underwent successful DES implantation. Patients were grouped into tertiles according to preprocedural CRP values for data analysis. Interventions: Successful DES implantation. Main outcome measures: The primary end point was a major coronary event, defined as cardiac death or Q-wave myocardial infarction. Results: Baseline clinical and angiographic characteristics were similar between the tertile groups, except that more patients had multivessel disease and acute coronary syndrome with increasing tertiles of CRP levels. At 1-year follow-up, a primary end point occurred in 4 (0.7%) patients of the lowest tertile, in 3 (0.5%) patients of the middle tertile and in 16 (2.9%) patients of the highest tertile (p = 0.003). In multivariate analysis, the highest tertile of CRP levels was an independent predictor of a major coronary event (HR 4.68, 95% CI 1.91 to 11.44, tertile III vs tertiles I and II, p = 0.001). However, restenosis rates were similar in all three groups (9.1% vs 11.4% vs 11.6%, respectively, p = 0.3). Conclusions: Preprocedural CRP levels are significantly associated with major coronary events after DES implantation. However, preprocedural CRP levels do not predict subsequent restenosis. Baseline CRP levels may be useful to guide adjunctive management for preventing serious ischaemic events in patients undergoing DES implantation.

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