Prognostic significance of high sensitivity C-reactive protein before and after percutaneous coronary intervention in patients with angina pectoris

ABSTRACT

C-reactive protein is an easily measurable acute phase reactant synthesized by hepatocytes in respone to pro-inflammatory cytokines. Elevated CRP has been identified as a strong predictor of prognosis in healthy individuals, in patients with stable angina, in unstable angina and in patients after acute myocardial infarction. The prognostic significance of high sensitivity CRP level in percutaneous coronary intervention is unclear. We prospectively studied 41 patients with chronic stable angina [28 patients] and unstable angina [13 patients] who underwent elective coronary stenting. All patients had normal troponin level before the procedure. Blood samples for hs-CRP were obtained before the procedure, 24 hours and 1 month after the procedure. Mean hs-CRP before the procedure in all patients who underwent PCI was 2.38 +/- 2.21 microg/ml. the mean hs-CRP 24 hours post procedure was 7.43=10.6 microg/ml. The mean hs-CRP after 1 month was 11.8=13.5 microg/ml. there was significant difference between pre procedural hs-CRP and 24 hours post procedural [P=0.007]and there was significant difference between pre procedural hs-CRP and 1 month post procedural [P=0.000]. At follow up period [1 month]. No major adverse cardiac events [MACE] have occurred. However, 24 patients complained of chest pain. There was no significant correlation between either pre-procedural, or 24 hours post procedure hs-CRP and chest pain [r=0.13, 0.2 respectively] Mechanical disruption of atherosclerotic plaque during coronary stent implantation causesasystemic inflammatory respone. We did not find that measuring hs-CRP level pre or post procedural is useful for predicting 30 days cardiac events