van der Harst Pim, Voors Adriaan A, Volbeda Meint, Buikema Hendrik, van Veldhuisen Dirk J, van Gilst Wiek H
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Am J Cardiol. 2006 Jun 15;97(12):1697-701. doi: 10.1016/j.amjcard.2006.01.030. Epub 2006 Apr 21.
High levels of C-reactive protein and soluble intercellular adhesion molecule-1 are associated with increased risk for cardiovascular events. No long-term data are available on predictive value of preoperative levels of C-reactive protein and soluble intercellular adhesion molecule-1 on outcome after coronary artery bypass grafting. We measured baseline levels of C-reactive protein and soluble intercellular adhesion molecule-1 in preoperative serum stored at -80 degrees C in 87 patients with coronary artery disease before undergoing isolated coronary artery bypass grafting. Follow-up was performed after a mean duration of 7.6+/-0.1 years, and all cardiovascular events were recorded. Data were analyzed by categorizing patients into 2 groups according to median value of C-reactive protein and soluble intercellular adhesion molecule-1. During follow-up, 16 patients developed a cardiovascular event. In patients with C-reactive protein above the median (1.9 mg/L), the cumulative cardiovascular event incidence was 29% compared with 9% in patients with levels below the median (p=0.048). In Cox regression analysis that was corrected for age, gender, and conventional risk factors, the adjusted relative risk of cardiovascular events of C-reactive protein above the median was 3.9 (95% confidence interval 1.1 to 13.9, p <0.05). Soluble intercellular adhesion molecule-1 level above the median (136 microg/L) was associated with a cumulative cardiovascular event incidence of 21% versus 16% below the median (p=0.48). In conclusion, in patients who undergo coronary artery bypass grafting, high preoperative levels of C-reactive protein levels, but not of soluble intercellular adhesion molecule-1, were associated with long-term risk of cardiovascular events, independent of other cardiac risk factors.
高浓度的C反应蛋白和可溶性细胞间黏附分子-1与心血管事件风险增加相关。目前尚无关于冠状动脉搭桥术后C反应蛋白和可溶性细胞间黏附分子-1术前水平对预后预测价值的长期数据。我们在87例冠心病患者行单纯冠状动脉搭桥术前，测量了储存在-80℃的术前血清中C反应蛋白和可溶性细胞间黏附分子-1的基线水平。平均随访7.6±0.1年，记录所有心血管事件。根据C反应蛋白和可溶性细胞间黏附分子-1的中位数将患者分为两组进行数据分析。随访期间，16例患者发生心血管事件。C反应蛋白高于中位数（1.9mg/L）的患者，心血管事件累积发生率为29%，而低于中位数水平的患者为9%（p=0.048）。在对年龄、性别和传统危险因素进行校正的Cox回归分析中，C反应蛋白高于中位数的心血管事件调整相对风险为3.9（95%置信区间1.1至13.9，p<0.05）。可溶性细胞间黏附分子-1水平高于中位数（136μg/L）的患者心血管事件累积发生率为21%，而低于中位数水平的患者为16%（p=0.48）。总之，在接受冠状动脉搭桥术的患者中，术前高C反应蛋白水平而非可溶性细胞间黏附分子-1水平与心血管事件的长期风险相关，且独立于其他心脏危险因素。
