C-reactive protein as a pre-procedural predictor of early and late outcomes of percutaneous coronary interventions

Abstract

To examine the predictive value of pre-procedural CRP level in patients undergoing percutaneous coronary intervention (PCI) regardless of having unstable or stable angina pectoris or myocardial infarction. Blood sampling for CRP measurement in patients undergoing PCI: 116 consecutive patients who underwent single vessel PCI were evaluated. Exclusion criteria were multilesion PCI, total occlusion, left ventricular ejection fraction < 30%, left bundle branch block and intercurrent inflammatory conditions known to be associated with an acute phase response. Major adverse coronary events (MACE) were defined as the occurrence of death, fatal or nonfatal myocardial infarction, and need for coronary artery revascularization with either bypass grafting or repeat angioplasty. End-points were assessed at hospital discharge, 30 days, 3 and 6 months following the index procedure. 62 (53%) patients had CRP levels < 0.5 mg/dl, and 54 (47%) had > 0.5 mg/dl. There were no significant difference in the occurrence of MACE in early in-hospital and 30 days follow up periods, between the two groups (0 vs. 5.5%) (p = ns) whereas the incidence of MACE after 3 months of the procedure was significantly different between the two groups (1.6 vs. 11%) (p < 0.05) and also after 6 months (9.5 vs 24.5%) (p < 0.05). The negative predictive value of CRP measurement is 98.4%. High levels of pre-procedural CRP show association with the higher incidence of MACE after 3 months of the follow-up period and negative CRP tests seems to have high predictive value to compare the patients who will be free of MACE after successful PCI.