Journal
ATHEROSCLEROSIS
Volume 320, Issue -, Pages 31-37Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.atherosclerosis.2021.01.012
Keywords
Biomarkers; Inflammation; CRP; Myocardial infarction; Risk factors
Funding
- Swiss National Science Foundation [SPUM 33CM30-124112, 32473B_163271]
- Swiss Heart Foundation
- Foundation Leducq
- Foundation for Cardiovascular Research - Zurich Heart House, Zurich
- Roche Diagnostics, Rotkreuz, Switzerland
- Eli Lilly, Indianapolis (USA)
- AstraZeneca, Zug
- Medtronic, Munchenbuchsee
- Merck Sharpe and Dome (MSD), Lucerne
- Sanofi-Aventis, Vernier
- St. Jude Medical, Zurich
Ask authors/readers for more resources
The study found that patients with persistently elevated hsCRP after ACS have a higher risk of combined adverse events, highlighting the need for anti-inflammatory intervention trials in RIR patients.
Background and aims: Residual inflammatory risk (RIR) after acute coronary syndromes (ACS) may identify patients likely to benefit from anti-inflammatory therapies. Methods: Patients from the Special Program University Medicine ACS cohort were divided into four groups according to level of hsCRP at baseline and after 12 months: persistently high RIR, increased RIR (first low, then high hsCRP), attenuated RIR (first high, then low hsCRP), or persistently low RIR. High RIR was defined as hsCRP >= 2 mg/L. An independently adjudicated incident of combined adverse events was defined as the composite of myocardial infarction, clinically indicated coronary revascularization or cerebrovascular events. Results: Among 1209 patients with available hsCRP, clinical and demographic data, 295 (24.4%) patients had persistently high RIR (delta hsCRP median (IQR): 2.3 (-9.9; 0.3) (mg/L) and 72 (5.96%) patients had increased RIR (delta hsCRP median (IQR): +2.45 (1.2; 8.35) (mg/L). A total of 390 (32.26%) patients had attenuated RIR (delta hsCRP median (IQR): 3.55 (-10;-2) (mg/L) and 452 (37.38%) patients had persistently low RIR (delta hsCRP median (IQR): 0.2 (-0.6; 0.1) (mg/L). Of 90 combined adverse events, 31 (10.5%) occurred in the persistently high (multivariable adjusted OR: 1.71, (95% CI 1.08-2.7), p = 0.022) compared with the three other groups combined (increased RIR: 3 (4.2%), attenuated RIR 30 (7.7%), persistently low RIR 26 (5.8%). Conclusions: Persistently elevated hsCRP after ACS is found in a quarter of patients with the highest risk of combined adverse events. This underlines the need to perform anti-inflammatory intervention trials in RIR patients.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available