hsCRP 升高的患病率和预后影响在接受经皮冠状动脉介入治疗的女性中与年龄相关，但在男性中则不相关。

Prevalence and prognostic impact of hsCRP elevation are age-dependent in women but not in men undergoing percutaneous coronary intervention.

机构信息

The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Department of Internal Medicine/Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

出版信息

Catheter Cardiovasc Interv. 2021 Jun 1;97(7):E936-E944. doi: 10.1002/ccd.29402. Epub 2020 Nov 25.

DOI:10.1002/ccd.29402

PMID:33236497

Abstract

BACKGROUND

High-sensitivity C-reactive protein (hsCRP) predicts outcomes after percutaneous coronary intervention (PCI).

OBJECTIVE

We studied the prevalence and prognostic impact of hsCRP elevation according to age in men and women undergoing PCI.

METHODS

We included patients undergoing PCI at our center from 2010 until 2017, excluding those with myocardial infarction (MI) on presentation, neoplastic disease and hsCRP >10 mg/L at baseline. Elevated hsCRP was defined as >3 mg/L. The outcome of interest was major adverse cardiac events (MACE) consisting of all-cause death, MI and target vessel revascularization. The association between hsCRP elevation and outcomes was assessed using adjusted Cox models.

RESULTS

10,432 men and 4,345 women were included. Elevation of hsCRP was present in 25.7% of men and 37.0% of women (p < .01). In men, prevalence of hsCRP elevation was stable across age strata (p = .42). In women, hsCRP elevation was most prevalent in patients <50 years (44.6%) and decreased stepwise with increasing age (p < .001). After stratifying the population into age quartiles (Q1: <59 years, Q2: 59-66 years, Q3: 67-74 years, Q4: ≥75 years), hsCRP elevation was associated with increased risk of MACE across all age groups in men (HR [95% CI] Q1: 1.49 [1.12-1.98]; Q2: 1.51 [1.21-2.06]; Q3: 1.76 [1.27-2.51]; Q4: 1.43[1.03-1.97]). In women, hsCRP elevation was associated with increased risk of MACE only among older patients (HR [95% CI] Q1: 1.08 [0.64-0.82]; Q2: 1.52 [0.93-2.46]; Q3: 1.65 [1.08-2.50]; Q4: 1.52 [1.02-1.28]).

CONCLUSION

Among patients undergoing PCI, prevalence and prognostic value of hsCRP elevation were age-dependent exclusively in women.

摘要

背景

高敏 C 反应蛋白（hsCRP）可预测经皮冠状动脉介入治疗（PCI）后的结局。

目的

我们研究了在接受 PCI 的男性和女性中，根据年龄，hsCRP 升高的发生率和预后影响。

方法

我们纳入了 2010 年至 2017 年在我们中心接受 PCI 的患者，排除了就诊时发生心肌梗死（MI）、肿瘤疾病和基线 hsCRP>10mg/L 的患者。hsCRP 升高定义为>3mg/L。主要不良心脏事件（MACE）是我们的研究终点，包括全因死亡、MI 和靶血管血运重建。使用校正的 Cox 模型评估 hsCRP 升高与结局之间的关系。

结果

共纳入 10432 名男性和 4345 名女性。男性中 hsCRP 升高的发生率为 25.7%，女性为 37.0%（p<0.01）。在男性中，hsCRP 升高的发生率在各年龄组之间保持稳定（p=0.42）。在女性中，hsCRP 升高最常见于<50 岁的患者（44.6%），且随着年龄的增加逐渐降低（p<0.001）。将人群分为年龄四分位（Q1：<59 岁，Q2：59-66 岁，Q3：67-74 岁，Q4：≥75 岁）后，hsCRP 升高与男性各年龄段的 MACE 风险增加相关（HR[95%CI]Q1：1.49[1.12-1.98]；Q2：1.51[1.21-2.06]；Q3：1.76[1.27-2.51]；Q4：1.43[1.03-1.97]）。在女性中，hsCRP 升高仅与老年患者的 MACE 风险增加相关（HR[95%CI]Q1：1.08[0.64-0.82]；Q2：1.52[0.93-2.46]；Q3：1.65[1.08-2.50]；Q4：1.52[1.02-1.28]）。