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Clinical Chemistry 51: 2124-2130, 2005. First published September 15, 2005; 10.1373/clinchem.2005.048082
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(Clinical Chemistry. 2005;51:2124-2130.)
© 2005 American Association for Clinical Chemistry, Inc.

Clinical Immunology

Response of Serum C-Reactive Protein to Percutaneous Coronary Intervention Has Prognostic Value

Nawsad Saleh1,a, Bertil Svane4, Lars-Olof Hansson3, Jens Jensen1, Tage Nilsson4, Olle Danielsson2 and Per Tornvall1

Departments of1 Cardiology,2 Clinical Chemistry, and4 Physiology and Thoracic Radiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
3 Department of Clinical Chemistry and Pharmacology, Uppsala University Hospital, Uppsala, Sweden.

aAddress correspondence to this author at: Department of Cardiology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden. Fax 46-8-32-45-97; e-mail nawzad.saleh{at}karolinska.se.

Background: Data are sparse regarding the association between C-reactive protein (CRP) and percutaneous coronary intervention (PCI) in long-term prognosis. Previous studies have shown that PCI evokes an inflammatory response. We tested the hypothesis that the CRP response to PCI has a prognostic value.

Methods: We investigated 891 consecutive patients presenting with stable or unstable angina pectoris, with serum concentrations of cardiac troponin T ≤0.03 µg/L, who were undergoing a variety of PCIs. Serum concentrations of CRP and cardiac troponin T were determined before and the day after PCI. The mean follow-up time after PCI was 2.6 years, and the endpoint was death or nonfatal myocardial infarction.

Results: Seventy-six patients reached the endpoint (4.6% death, 3.9% nonfatal myocardial infarction), whereas 21% developed myocardial infarction during the procedure. CRP increased more than 2-fold after the procedure. Patients in the third tertile of the CRP response to PCI had an increased risk for death or nonfatal myocardial infarction in multivariate analysis.

Conclusions: Increased serum CRP in response to PCI is an independent predictor of death or nonfatal myocardial infarction independent of myocardial injury during the procedure. CRP determinations might be of value in risk stratification after PCI.






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Copyright © 2005 by the American Association for Clinical Chemistry.