A persistent increase in C-reactive protein is a risk factor for restenosis in patients with stable angina who are not receiving statins

Atherosclerosis. 2004 Apr;173(2):285-90. doi: 10.1016/j.atherosclerosis.2003.12.017.

Abstract

Inflammation has been postulated to be a major contributor to restenosis after angioplasty. We examined the correlation between inflammatory and coagulatory reactions and the occurrence of restenosis, and how treatment with statins influences this correlation. A total of 243 patients with stable angina who were scheduled for a percutaneous coronary intervention (PCI) and follow-up coronary angiography were enrolled in the study. Eighty-one of these patients were treated with statins for at least 1 month before their PCI and throughout the study period. Blood was withdrawn on the day of the PCI and on the day of the follow-up catheterization. Patients with the highest hs-CRP at the time of the initial PCI maintained elevated hs-CRP levels over time and showed significantly higher rates of restenosis or TLR after 6 +/- 1 months than subjects with low initial hs-CRP. Statin treatment abolished this difference. Fibrinogen levels were also increased in subjects with high initial hs-CRP, both at the time of the initial PCI and at follow-up. In an univariate analysis, both initial and follow-up levels of hs-CRP and fibrinogen correlated with restenosis. However, both the initial and follow-up levels of hs-CRP only were independent predictors of increased restenosis in a multivariate analysis, except in the statin-treated subgroup. In conclusions, the persistent increase in CRP is a risk factor for restenosis in patients with stable angina who have not been treated with statins.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Analysis of Variance
  • Angina Pectoris / diagnosis*
  • Angina Pectoris / therapy
  • Angioplasty, Balloon, Coronary / methods
  • C-Reactive Protein / analysis*
  • Cohort Studies
  • Coronary Angiography
  • Coronary Restenosis / diagnosis*
  • Coronary Restenosis / epidemiology
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Incidence
  • Inflammation Mediators / blood*
  • Logistic Models
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Probability
  • Prognosis
  • Risk Assessment
  • Sensitivity and Specificity

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Inflammation Mediators
  • C-Reactive Protein