An elevated value of C-reactive protein is the only predictive factor of restenosis after percutaneous coronary intervention

Jeong, Woo Kon; Jeong, Myung Ho; Kim, Kye Hun; Lee, Sang Rok; Park, Ok Young; Yum, Ju Hyup; Kim, Won; Kim, Ju Han; Rhew, Jae Young; Ahn, Youn Keun; Cho, Jeong Gwan; Ahn, Byoung Hee; Suh, Soon Pal; Park, Jong Chun; Kim, Sang Hyung; Kang, Jung Chaee

Abstract

BACKGROUND
Current techniques of percutaneous coronary interventions (PCI) remain limited by the restenosis. Recent studies provide evidence that inflammation plays a role in the pathogenesis of cardiovascular disease.
METHODS
We prospectively tested whether inflammatory markers are predictors of subsequent restenosis in 272 consecutive patients with angiographically proved coronary artery disease. The patients who underwent PCI at Chonnam National University Hospital between Sep. 1999 and Mar. 2001 were divided into two groups according to the occurrence of restenosis on follow-up coronary angiogram: patients with restenosis (Group I : n=99, 59.5 10.8 years, M : F=77:22) and patients without restenosis (Group II : n=173, 58.8 10.2 years, M : F=131:42). IgG seropositivity and titer of CMV, C. pneumoniae, H. pylori, levels of C-reactive protein (CRP) were compared between two groups.
RESULTS
There were no statistical differences in the seropositivity of CMV IgG, C. pneumoniae IgG, H. pylori IgG between two groups (Group I vs. II : 100% vs. 100%, 24.7% vs. 25.7%, 62.2% vs. 63.7% in group I vs. II respectively). Among angiographic parameters, low TIMI flow (TIMI 0 or I) was more common in Group I than in Group II (p=0.038). The patients with elevated CRP (>0.5 mg/dL) were more common in Group I than those in Group II (57.6% vs. 36.4%, p=0.001) and the value of CRP was higher in Group I than in Group II (3.3+/-5.8 mg/dL vs. 1.3+/-2.6 mg/dL, p=0.001). According to multiple logistic regression analysis, CRP was the only predictor of restenosis with odd ratio of 2.1169 (95% C.I. 1.2062-3.7154, p=0.009).
CONCLUSION
The value of CRP is the most important predictor of restenosis after PCI.