Prognostic value of high-sensitivity C-reactive protein among chronic kidney disease patients undergoing percutaneous coronary intervention

Davis Jones, Alessandro Spirito, Samantha Sartori, Kenneth F. Smith, Carlo Andrea Pivato, Mauro Chiarito, Davide Cao, Johny Nicolas, Frans Beerkens, Madison Edens, Brunna Pileggi, Ananya Sen, Zhongjie Zhang, Birgit Vogel, Joseph Sweeny, Usman Baber, George Dangas, Samin K. Sharma, Annapoorna Kini, Roxana Mehran

Research output: Contribution to journalArticlepeer-review


Background: Data on the prognostic value of high-sensitivity C-reactive protein (hs-CRP) levels in patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI) are limited. Methods: Patients undergoing PCI at a tertiary center from January 2012 to December 2019 were included. CKD was defined as a glomerular filtration rate (GFR) <60 mL/min/1.73m2 and elevated hs-CRP was defined as >3 mg/L. Acute myocardial infarction (MI), acute heart failure, neoplastic disease, patients undergoing hemodialysis, or hs-CRP >10 mg/L were exclusion criteria. The primary outcome was major adverse cardiac events (MACE), a composite of all-cause death, MI, and target vessel revascularization at 1-year after PCI. Results: Out of 12,410 patients, 3029 (24.4 %) had CKD. Elevated hs-CRP levels were found in 31.8 % of CKD and 25.8 % of no-CKD patients. At 1 year, MACE occurred in 87 (11.0 %) CKD patients with elevated hs-CRP and 163 (9.5 %) with low hs-CRP (adj. HR 1.26, 95 % CI 0.94–1.68); among no-CKD patients, in 200 (10 %) and 470 (8.1 %), respectively (adj. HR 1.21, 95 % CI 1.00–1.45). Hs-CRP was associated with an increased risk of all-cause death in both CKD (Adj. HR 1.92, 95 % CI 1.07–3.44) and no-CKD patients (adj. HR 3.02, 95 % CI 1.74–5.22). There was no interaction between hs-CRP and CKD status. Conclusions: Among patients undergoing PCI without acute MI, elevated hs-CRP values were not associated with a higher risk of MACE at 1 year, but with increased mortality hazards consistently in patients with or without CKD.

Original languageEnglish
Pages (from-to)179-185
Number of pages7
JournalJournal of Cardiology
Issue number3
StatePublished - Sep 2023


  • Chronic kidney disease
  • High-sensitivity C-reactive protein
  • Percutaneous coronary intervention


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