Hsieh I-Chang, Chen Chun-Chi, Hsieh Ming-Jer, Yang Chia-Hung, Chen Dong-Yi, Chang Shang-Hung, Wang Chao-Yung, Lee Cheng-Hung, Tsai Ming-Lung
Department of Cardiology, Percutaneous Coronary Intervention Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou, Taoyuan, Taiwan.
PLoS One. 2015 Sep 25;10(9):e0138512. doi: 10.1371/journal.pone.0138512. eCollection 2015.
The level of 9-month high-sensitivity C-reactive protein (hsCRP) in predicting cardiovascular outcomes is scanty in patients at 9 months after receiving drug-eluting stent (DES) implantations. This study aims to evaluate the relationship between 9-month follow-up hsCRP levels and long-term clinical outcomes in patients at 9 months after receiving DES.
A total of 1,763 patients who received 9-month follow-up angiography were enrolled and grouped according to hsCRP level 9 months after the DES implantation: group I (718 patients, hsCRP<1.0 mg/L), group II (639 patients, 1.0 ≦ hsCRP ≦ 3.0 mg/L), and group III (406 patients, hsCRP>3.0 mg/L).
Group III patients had a lower cardiovascular event-free survival rate than group I or II patients during a follow-up of 64 ± 45 months (64.5% vs. 71.6% vs. 72.8%, respectively, p = 0.012). Multivariate analysis showed that a follow-up hsCRP level <3.0 mg/L was an independent predictor of a major adverse cardiovascular event (cardiac death, reinfarction, target lesion revascularization, stenting in a new lesion, or coronary bypass surgery). Group III patients had a higher restenosis rate (11.3% vs. 5.8% vs. 6.6%, respectively, p = 0.002) and loss index (0.21 ± 0.32 vs. 0.16 ± 0.24 vs. 0.18 ± 0.28, respectively, p = 0.001) than group I or II patients in 9-month follow-up angiography.
A high 9-month follow-up hsCRP level is an independent predictor of long-term clinical cardiovascular outcomes in patients at 9 months after DES implantation. It is also associated with a higher restenosis rate, larger late loss and loss index at 9 months after DES implantation.
在接受药物洗脱支架（DES）植入术后9个月的患者中，关于9个月高敏C反应蛋白（hsCRP）水平预测心血管结局的研究较少。本研究旨在评估DES植入术后9个月患者的9个月随访hsCRP水平与长期临床结局之间的关系。
共纳入1763例接受9个月随访血管造影的患者，并根据DES植入术后9个月的hsCRP水平进行分组：I组（718例患者，hsCRP<1.0 mg/L），II组（639例患者，1.0≦hsCRP≦3.0 mg/L），III组（406例患者，hsCRP>3.0 mg/L）。
在64±45个月的随访期间，III组患者的无心血管事件生存率低于I组或II组患者（分别为64.5%、71.6%和72.8%，p = 0.012）。多因素分析显示，随访hsCRP水平<3.0 mg/L是主要不良心血管事件（心源性死亡、再梗死、靶病变血管重建、新病变支架置入或冠状动脉搭桥手术）的独立预测因素。在9个月随访血管造影中，III组患者的再狭窄率（分别为11.3%、5.8%和6.6%，p = 0.002）和丢失指数（分别为0.21±0.32、0.16±0.24和0.18±0.28，p = 0.001）高于I组或II组患者。
DES植入术后9个月时，较高的9个月随访hsCRP水平是患者长期临床心血管结局的独立预测因素。它还与DES植入术后9个月时较高的再狭窄率、更大的晚期管腔丢失和丢失指数相关。
