Role of plasma C-reactive protein in predicting in-stent restenosis in patients with stable angina after coronary stenting

• Published in: Chinese medical journal Vol. 124; no. 6; pp. 845 - 850
• Main Authors: Xu, Yan-lu, Li, Jian-jun, Xu, Bo, Zhu, Cheng-gang, Yang, Yue-jin, Chen, Ji-lin, Qiao, Shu-bin, Yuan, Jin-qing, Qin, Xue-wen, Ma, Wei-hua, Yao, Min, Liu, Hai-bo, Wu, Yong-jian, Chen, Jue, You, Shi-jie, Dai, Jun, Xia, Ran, Gao, Run-lin
• Format: Journal Article
• Language: English
• Published: China Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China 01.03.2011
• Subjects: Aged; Angina Pectoris - therapy; C-Reactive Protein - metabolism; Coronary Restenosis - blood; Coronary Restenosis - therapy; C反应蛋白; Female; Humans; Male; Middle Aged; Multivariate Analysis; 再狭窄; 冠状动脉支架; 后支架; 心绞痛; 稳定型; 预测值; high sensitivity C-reactive protein; inflammation; in-stent restenosis; stable angina
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2011.06.008

Background The role of plasma high sensitivity C-reactive protein （hs-CRP） in in-stent restenosis （ISR） remains controversial. We investigated plasma hs-CRP level at both admission and follow-up in patients with stable angina （SA）after successful coronary stenting in order to clarify the predictive value of hs-CRP for ISR.Methods We summarized 303 consecutive chronic SA patients with coronary drug-eluting stent （DES） implantation.The ISR was analyzed by quantitative coronary analysis （QCA） at a mean follow-up of 8 months, and the patients were divided into two groups according to the detected ISR as ISR group （n=48） and non-ISR group （n=255）. Plasma hs-CRP was examined at both admission and 8-month follow-up in all patients, standard medication continued throughout the investigation period.Results QCA presented that 48 patients （15.8%） suffered from ISR at follow-up. The basic clinical characteristics were similar between the two groups, while plasma hs-CRP was higher in ISR group than that in non-ISR group at both admission and follow-up, P 〈0.001 respectively. Multivariate regression analysis indicated that plasma hs-CRP level at either admission or follow-up could independently predict ISR occurrence （OR=5.581, 95% Cl 2.532-12.302, P〈0.001and OR=6.299, 95% CI 2.722-14.577, P 〈0.001, respectively）.Conclusions Our data indicate that plasma hs-CRP level may independently predict ISR at both admission and follow-up in SA patients with coronary DES implantation, which implies that a chronic, sustained systemic inflammatory response might be involved in ISR pathogenesis.