Baseline levels of serum high sensitivity C reactive protein and lipids in predicting the residual risk of cardiovascular events in Chinese population with stable coronary artery disease: a prospective cohort study

BACKGROUND: The contributions of inflammation, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) to the residual risk of cardiovascular events have not been determined in a large cohort of Chinese population before. This study was aimed to investigate the association of serum levels of high sensitive C reactive protein (hs-CRP), TG and HDL-C with the residual risk of cardiovascular events in patients with stable coronary artery disease (CAD). METHODS: We enrolled 4090 patients with stable CAD from 13 hospitals in China. All participants received optimal medical treatment (OMT) for stable CAD suggested by guidelines and were followed. The endpoint measures were the first occurrence of a major adverse cardiovascular event (MACE), defined as cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or unplanned coronary revascularization. Cox proportional regression analysis was conducted to identify independent predictors of MACE. RESULTS: We found that hs-CRP and HDL-C levels were associated with coronary lesion severity at baseline (both p < 0.001). After 3 months OMT, 91.2% (3730/4090) patients achieved the therapeutic goal for low density lipoprotein cholesterol (LDL-C) (< 1.8 mmoL/L). During a mean follow-up period of 39.5 months, 11.5% (471/4090) patients suffered MACE. In multivariate Cox proportional regression analysis, the hazard ratio for MACE was 1.17 (95% confidence interval: 1.07–1.28, p < 0.001) per standardized deviation in the log-transformed hs-CRP levels after adjustment for other traditional cardiovascular risk factors. However, baseline TG and HDL-C levels were not associated with MACE in this study. CONCLUSIONS: Baseline hs-CRP level was an independent predictor of residual risk of cardiovascular events in Chinese population with stable CAD. However, TG and HDL-C levels were not associated with MACE.