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Both Low and High Postprocedural hsCRP Associate with Increased Risk of Death in Acute Coronary Syndrome Patients Treated by Percutaneous Coronary Intervention

BACKGROUND: Inflammation poses dual effects after myocardial infarction, but robust evidence shows that high-sensitivity C-reactive protein (hsCRP), as an inflammatory marker, is constantly associated with worse outcomes. This study is aimed at investigating the probable nonlinear association betwee...

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Autores principales: Chen, Runzhen, Liu, Chen, Zhou, Peng, Tan, Yu, Sheng, Zhaoxue, Li, Jiannan, Zhou, Jinying, Chen, Yi, Song, Li, Zhao, Hanjun, Yan, Hongbing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183527/
https://www.ncbi.nlm.nih.gov/pubmed/32377168
http://dx.doi.org/10.1155/2020/9343475
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author Chen, Runzhen
Liu, Chen
Zhou, Peng
Tan, Yu
Sheng, Zhaoxue
Li, Jiannan
Zhou, Jinying
Chen, Yi
Song, Li
Zhao, Hanjun
Yan, Hongbing
author_facet Chen, Runzhen
Liu, Chen
Zhou, Peng
Tan, Yu
Sheng, Zhaoxue
Li, Jiannan
Zhou, Jinying
Chen, Yi
Song, Li
Zhao, Hanjun
Yan, Hongbing
author_sort Chen, Runzhen
collection PubMed
description BACKGROUND: Inflammation poses dual effects after myocardial infarction, but robust evidence shows that high-sensitivity C-reactive protein (hsCRP), as an inflammatory marker, is constantly associated with worse outcomes. This study is aimed at investigating the probable nonlinear association between postprocedural hsCRP and mortality in patients with acute coronary syndromes (ACS) treated by percutaneous coronary intervention (PCI). METHODS: A total of 3940 consecutive ACS patients treated by PCI with postprocedural hsCRP measurements were retrospectively recruited. Patients were stratified into 5 groups according to quintiles of hsCRP. Cox regression with adjustments for multiple covariates was used for outcome analysis. Restricted cubic spline (RCS) analysis was used to allow possible nonlinear associations. The primary outcome was all-cause death. RESULTS: During a median follow-up of 727 days, mortality occurred in 207 (5.3%) patients. Adjusted hazard ratio (HR) was higher in the lowest (<2.26 mg/L, HR: 1.90, 95% confidence interval (CI): 1.08-3.33; P = 0.025), second highest (10.16-12.56 mg/L, HR: 1.86, 95% CI: 1.09-3.16; P = 0.023), and highest quintiles (≥12.56 mg/L, HR: 2.02, 95% CI: 1.21-3.36; P = 0.007) of postprocedural hsCRP, compared to the second lowest quintile (2.26-4.85 mg/L). RCS analysis depicted a J-shaped association between postprocedural hsCRP and mortality (P for nonlinearity = 0.004). Similar association was observed between hsCRP and cardiac death (P for nonlinearity = 0.014), but not for noncardiac mortality (P for nonlinearity = 0.228). CONCLUSIONS: Both low and high postprocedural hsCRP were associated with higher risk of death in ACS patients treated by PCI.
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spelling pubmed-71835272020-05-06 Both Low and High Postprocedural hsCRP Associate with Increased Risk of Death in Acute Coronary Syndrome Patients Treated by Percutaneous Coronary Intervention Chen, Runzhen Liu, Chen Zhou, Peng Tan, Yu Sheng, Zhaoxue Li, Jiannan Zhou, Jinying Chen, Yi Song, Li Zhao, Hanjun Yan, Hongbing Mediators Inflamm Clinical Study BACKGROUND: Inflammation poses dual effects after myocardial infarction, but robust evidence shows that high-sensitivity C-reactive protein (hsCRP), as an inflammatory marker, is constantly associated with worse outcomes. This study is aimed at investigating the probable nonlinear association between postprocedural hsCRP and mortality in patients with acute coronary syndromes (ACS) treated by percutaneous coronary intervention (PCI). METHODS: A total of 3940 consecutive ACS patients treated by PCI with postprocedural hsCRP measurements were retrospectively recruited. Patients were stratified into 5 groups according to quintiles of hsCRP. Cox regression with adjustments for multiple covariates was used for outcome analysis. Restricted cubic spline (RCS) analysis was used to allow possible nonlinear associations. The primary outcome was all-cause death. RESULTS: During a median follow-up of 727 days, mortality occurred in 207 (5.3%) patients. Adjusted hazard ratio (HR) was higher in the lowest (<2.26 mg/L, HR: 1.90, 95% confidence interval (CI): 1.08-3.33; P = 0.025), second highest (10.16-12.56 mg/L, HR: 1.86, 95% CI: 1.09-3.16; P = 0.023), and highest quintiles (≥12.56 mg/L, HR: 2.02, 95% CI: 1.21-3.36; P = 0.007) of postprocedural hsCRP, compared to the second lowest quintile (2.26-4.85 mg/L). RCS analysis depicted a J-shaped association between postprocedural hsCRP and mortality (P for nonlinearity = 0.004). Similar association was observed between hsCRP and cardiac death (P for nonlinearity = 0.014), but not for noncardiac mortality (P for nonlinearity = 0.228). CONCLUSIONS: Both low and high postprocedural hsCRP were associated with higher risk of death in ACS patients treated by PCI. Hindawi 2020-04-17 /pmc/articles/PMC7183527/ /pubmed/32377168 http://dx.doi.org/10.1155/2020/9343475 Text en Copyright © 2020 Runzhen Chen et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Chen, Runzhen
Liu, Chen
Zhou, Peng
Tan, Yu
Sheng, Zhaoxue
Li, Jiannan
Zhou, Jinying
Chen, Yi
Song, Li
Zhao, Hanjun
Yan, Hongbing
Both Low and High Postprocedural hsCRP Associate with Increased Risk of Death in Acute Coronary Syndrome Patients Treated by Percutaneous Coronary Intervention
title Both Low and High Postprocedural hsCRP Associate with Increased Risk of Death in Acute Coronary Syndrome Patients Treated by Percutaneous Coronary Intervention
title_full Both Low and High Postprocedural hsCRP Associate with Increased Risk of Death in Acute Coronary Syndrome Patients Treated by Percutaneous Coronary Intervention
title_fullStr Both Low and High Postprocedural hsCRP Associate with Increased Risk of Death in Acute Coronary Syndrome Patients Treated by Percutaneous Coronary Intervention
title_full_unstemmed Both Low and High Postprocedural hsCRP Associate with Increased Risk of Death in Acute Coronary Syndrome Patients Treated by Percutaneous Coronary Intervention
title_short Both Low and High Postprocedural hsCRP Associate with Increased Risk of Death in Acute Coronary Syndrome Patients Treated by Percutaneous Coronary Intervention
title_sort both low and high postprocedural hscrp associate with increased risk of death in acute coronary syndrome patients treated by percutaneous coronary intervention
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183527/
https://www.ncbi.nlm.nih.gov/pubmed/32377168
http://dx.doi.org/10.1155/2020/9343475
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