Combined periprocedural evaluation of CRP and TNF-alpha enhances the prediction of clinical restenosis and major adverse cardiac events in patients undergoing percutaneous coronary interventions

• Published in: International journal of molecular medicine Vol. 16; no. 1; p. 173
• Main Authors: Kubica, Jacek, Kozinski, Marek, Krzewina-Kowalska, Anna, Zbikowska-Gotz, Magdalena, Dymek, Grazyna, Sukiennik, Adam, Piasecki, Radoslaw, Bogdan, Maria, Grzesk, Grzegorz, Chojnicki, Maciej, Dziedziczko, Andrzej, Sypniewska, Grazyna
• Format: Journal Article
• Language: English
• Published: Greece 01.07.2005
• Subjects: Aged; Angina Pectoris - blood; Angina Pectoris - pathology; Angina Pectoris - surgery; Angioplasty, Balloon, Coronary - adverse effects; Biomarkers - blood; C-Reactive Protein - metabolism; Coronary Restenosis - blood; Coronary Restenosis - diagnosis; Coronary Restenosis - pathology; Female; Follow-Up Studies; Humans; Inflammation - blood; Inflammation - pathology; Male; Middle Aged; Treatment Outcome; Tumor Necrosis Factor-alpha - metabolism
• ISSN: 1107-3756
• DOI: 10.3892/ijmm.16.1.173

To assess the value of serial C-reactive protein (CRP), serum amyloid A (SAA), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) evaluation in the risk stratification in patients undergoing percutaneous coronary intervention. The study was designed as a prospective cohort trial with a 1-year follow-up. Eighty patients (70 with stable angina, 10 with unstable angina) were enrolled. Blood samples were collected before the procedure and after 6 and 24 h, and 1 month. Clinical follow-up visits were performed (*with exercise test) 7 days* and 1*, 3, 6* and 12 months after the procedure. Any symptoms of restenosis were verified angiographically. Multivariate logistic regression analysis identified increased preprocedural TNF-alpha and CRP levels and elevated CRP concentrations evaluated 24 h after the procedure as significant predictors of both clinical restenosis and major adverse cardiac events (MACE), while high SAA values at 24 h accurately predicted clinical restenosis. Patients, who were in the highest tertile of, either, baseline TNF-alpha and/or baseline CRP/CRP at 24 h, were more prone to develop restenosis and MACE than stratified only on the basis of a single marker. Our data indicate that combined analysis of CRP and TNF-alpha might be an effective approach to the clinical restenosis and MACE prediction. Additionally, long-term outcome is markedly influenced by the periprocedural activation of inflammation.