Objective: To assess the prognostic value of the baseline C-reactive protein (CRP) level in patients undergoing percutaneous coronary intervention (PCI) after pre-treatment with 600 mg of clopidogrel and whether there is an interaction between CRP level and abciximab in terms of outcome.
Design: Pooled analysis from the ISAR-SWEET, SMART-2, ISAR-REACT, and REACT-2 trials.
Setting, Methods: The study included 4847 patients with coronary artery disease (CAD) undergoing PCI after pre-treatment with 600 mg of clopidogrel. The primary outcome was 1-year mortality. The combined incidence of death, myocardial infarction, and target lesion revascularization was the secondary outcome.
Results: Based on the median value of CRP (2.3 mg/L), patients were divided into 2 groups: the high-CRP group (n=2448) and the low-CRP group (n=2399). During 1-year, there were 141 deaths (5.8%) in the high-CRP group versus 51 deaths (2.1%) in the low-CRP group, (OR=2.77, 95%CI 2.04-3.77; p<0.001). The incidence of major adverse cardiac events (MACE) was 28% in the high-CRP group versus 25% in the low-CRP group (OR=1.13, 95%CI 1.01-1.26; p=0.034). The Cox proportional hazards model showed that high-CRP was an independent predictor of 1-year mortality (hazard ratio=2.20, 95%CI 1.54-3.15; P<0.001 for CRP level >2.3mg/L versus. CRP level ≤2.3mg/L). No significant interaction was observed between CRP level and abciximab regarding one-year mortality (P=0.08) or MACE (P=0.68).
Conclusion: In patients with CAD undergoing PCI after pre-treatment with 600mg of clopidogrel, baseline CRP level predicts 1-year mortality and MACE. Abciximab therapy did not confer any particular beneficial effect in patients with a higher inflammatory burden.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.