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

BackgroundC-reactive protein is an easily measurable acute phase reactant synthesized by hepatocytes in response 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.MethodsWe 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 h after the procedure. Patients followed up at 1 month and after 2 years.ResultsMean hs_CRP before the procedure in all patients underwent PCI was 2.38 ± 2.21 μg/ml. The mean hs_CRP 24 h post procedure was 7.43 ± 10.6 μg/ml .There was significant difference between pre procedural hs-CRP and 24 h post procedural (P = 0.007). At follow up period (1 month), no major adverse cardiac events (MACE) have occurred. However, 24 patients complain of chest pain. There was no significant correlation between either pre-procedural, or 24 h post procedure hs-CRP and chest pain (r = 0.13, 0.2, respectively). At follow up period (2 years), 7 cases missed; MACE has occurred in 13 patients.ConclusionMechanical disruption of atherosclerotic plaque during elective coronary stent implantation causes a systemic inflammatory response. Measuring of hs-CRP either pre-procedural or post procedural in low risk patients is not useful for predicting of either early or late cardiovascular events.