Background Although C-reactive protein (CRP) has been proposed as a useful biomarker for predicting atherothrombosis, the association of CRP levels and clinical outcomes after drug-eluting stent (DES) implantation has not been defined.

Objectives To assess the predictive value of CRP after drug-eluting stent (DES) implantation, especially the association of CRP levels with adverse clinical events, such as stent thrombosis, death, myocardial infarction (MI) and so on.

Methods We evaluated 2048 consecutive patients who underwent successful DES implantation. The primary outcomes were stent thrombosis, death, myocardial infarction (MI), and target vessel revascularisation.

Results After 2 years of follow-up, there were 11 stent thrombosis, 72 deaths, 113 MI, 133TVR. In multivariable Cox proportional-hazards models, the high CRP remained predictive of adverse cardiac events, elevated levels of CRP were significantly associated with increased risks of stent thrombosis (HR 4.08; 95% CI 1.91 to 11.44; p<0.001), death (HR 2.01; 95% CI 1.18 to 4.688; p=0.004), MI (HR 1.78; 95% CI 1.25 to 9.12; p=0.001), but not target vessel revascularisation (HR 1.20; 95% CI 0.59 to 1.16; p=0.62).

Conclusions Elevated CRP levels were significantly associated with major coronary events after DES implantation, such as stent thrombosis, death, and MI, demonstrating the additive impacts of active inflammation and myocardial injury on prognosis after DES implantation.