34736Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
Angiology. 2022 Jan;73(1):60-67. doi: 10.1177/00033197211021195. Epub 2021 Jun 10.
The prognostic value of high-sensitivity C-reactive protein (hsCRP) in complex coronary artery disease has not been fully established. We aimed to determine the association between hsCRP and long-term outcomes in elderly patients with 3-vessel disease (TVD). From April 2004 to February 2011, 3069 patients aged ≥65 years with TVD were consecutively enrolled and received medical treatment alone, percutaneous coronary intervention, or coronary artery bypass grafting. The patients were divided into 2 groups according to their hsCRP levels: <3.00 mg/L (62.1%) and ≥3.00 mg/L (37.9%). The mean age was 71 ± 4 years. The high hsCRP group had more risk factors and more frequently received conservative treatment than the low hsCRP group. During a median follow-up period of 6.2 years, elevated hsCRP was significantly associated with increased all-cause death (19.5% vs 29.6%, < .001), cardiac death (9.4% vs 15.2%, = .001), and major adverse cardiovascular and cerebrovascular events (34.1% vs 42.5%, = .001). Multivariable Cox regression analyses revealed that hsCRP was an independent predictor for all of these events. Combining hsCRP with Synergy between PCI with TAXUS and Cardiac Surgery score II further improved the predictive power of the score. The relationship between hsCRP and mortality was relatively consistent across subgroups. Overall, hsCRP could prove useful for risk prediction in elderly patients.
高敏 C 反应蛋白（hsCRP）在复杂冠状动脉疾病中的预后价值尚未完全确定。我们旨在确定 hsCRP 与 3 支血管病变（TVD）老年患者长期预后之间的关系。2004 年 4 月至 2011 年 2 月，连续纳入 3069 名年龄≥65 岁的 TVD 患者，他们单独接受药物治疗、经皮冠状动脉介入治疗或冠状动脉旁路移植术。根据 hsCRP 水平将患者分为两组：<3.00mg/L（62.1%）和≥3.00mg/L（37.9%）。平均年龄为 71±4 岁。hsCRP 水平较高的组比 hsCRP 水平较低的组有更多的危险因素，更常接受保守治疗。在中位随访 6.2 年期间，hsCRP 升高与全因死亡（19.5% vs. 29.6%，<0.001）、心脏性死亡（9.4% vs. 15.2%，=0.001）和主要不良心脑血管事件（34.1% vs. 42.5%，=0.001）显著相关。多变量 Cox 回归分析显示，hsCRP 是这些事件的独立预测因子。将 hsCRP 与 PCI 与 TAXUS 联合心脏手术评分 II 相结合，进一步提高了评分的预测能力。hsCRP 与死亡率之间的关系在各亚组中相对一致。总体而言，hsCRP 可用于预测老年患者的风险。
