Prevalence and prognostic impact of hsCRP elevation are age-dependent in women but not in men undergoing percutaneous coronary intervention

Moritz Blum, Davide Cao, Rishi Chandiramani, Ridhima Goel, Anastasios Roumeliotis, Samantha Sartori, Niklas Beyhoff, Sebastian Kelle, Jason C. Kovacic, Prakash Krishnan, Joseph Sweeny, Nitin Barman, Usman Baber, George D. Dangas, Annapoorna Kini, Samin K. Sharma, Roxana Mehran

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: High-sensitivity C-reactive protein (hsCRP) predicts outcomes after percutaneous coronary intervention (PCI). Objective: We studied the prevalence and prognostic impact of hsCRP elevation according to age in men and women undergoing PCI. Methods: We included patients undergoing PCI at our center from 2010 until 2017, excluding those with myocardial infarction (MI) on presentation, neoplastic disease and hsCRP >10 mg/L at baseline. Elevated hsCRP was defined as >3 mg/L. The outcome of interest was major adverse cardiac events (MACE) consisting of all-cause death, MI and target vessel revascularization. The association between hsCRP elevation and outcomes was assessed using adjusted Cox models. Results: 10,432 men and 4,345 women were included. Elevation of hsCRP was present in 25.7% of men and 37.0% of women (p <.01). In men, prevalence of hsCRP elevation was stable across age strata (ptrend =.42). In women, hsCRP elevation was most prevalent in patients <50 years (44.6%) and decreased stepwise with increasing age (ptrend <.001). After stratifying the population into age quartiles (Q1: <59 years, Q2: 59–66 years, Q3: 67–74 years, Q4: ≥75 years), hsCRP elevation was associated with increased risk of MACE across all age groups in men (HR [95% CI] Q1: 1.49 [1.12–1.98]; Q2: 1.51 [1.21–2.06]; Q3: 1.76 [1.27–2.51]; Q4: 1.43[1.03–1.97]). In women, hsCRP elevation was associated with increased risk of MACE only among older patients (HR [95% CI] Q1: 1.08 [0.64–0.82]; Q2: 1.52 [0.93–2.46]; Q3: 1.65 [1.08–2.50]; Q4: 1.52 [1.02–1.28]). Conclusion: Among patients undergoing PCI, prevalence and prognostic value of hsCRP elevation were age-dependent exclusively in women.

Original languageEnglish
Pages (from-to)E936-E944
JournalCatheterization and Cardiovascular Interventions
Volume97
Issue number7
DOIs
StatePublished - 1 Jun 2021

Keywords

  • coronary artery disease
  • inflammatory biomarkers
  • percutaneous coronary intervention

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