The prognostic value of pre-procedural plasma C-reactive protein in patients undergoing elective coronary angioplasty

Eur Heart J. 2002 Jun;23(12):960-6. doi: 10.1053/euhj.2001.2988.


Aims: The acute phase reactant C-reactive protein is an important prognostic risk factor in patients with both stable and unstable coronary artery disease. The potential prognostic implications of an abnormal pre-procedural C-reactive protein concentration in patients undergoing elective coronary angioplasty may be relevant for subsequent treatment.

Methods and results: Pre-procedural plasma levels of C-reactive protein were measured in 501 patients with stable coronary artery disease undergoing elective coronary angioplasty. The incidence of death or myocardial infarction during a 2-year follow-up was 10.6% (24/227) in patients with an increased C-reactive protein level (>3 mg. l(-1)) and 2.9% (8/274) in patients with a normal C-reactive protein level (RR 3.9, 95% CI 1.7-8.9). Survival without death, myocardial infarction, urgent revascularization or hospital admission for unstable angina was significantly lower in patients with an increased C-reactive protein vs patients with a normal C-reactive protein (log-rank 14.62, P<0.0001). Logistic regression analysis identified an increased C-reactive protein level as a strong independent predictor of event-free survival (RR 2.54, 95% CI: 1.44-4.47, P=0.001).

Conclusion: Pre-procedural C-reactive protein levels are increased in 45% of patients undergoing elective coronary angioplasty. An increased C-reactive protein level is a powerful independent prognostic indicator for subsequent cardiac events, suggesting that late clinical outcome is markedly influenced by pre-procedural systemic activation of inflammation.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary*
  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / metabolism
  • Coronary Artery Disease / therapy
  • Elective Surgical Procedures*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Netherlands / epidemiology
  • Patient Admission
  • Postoperative Complications / blood
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Predictive Value of Tests
  • Preoperative Care*
  • Prognosis
  • Risk Factors
  • Survival Analysis
  • Treatment Outcome


  • Biomarkers
  • C-Reactive Protein