Prognostic Impact of High-Sensitivity C-Reactive Protein in Patients Undergoing Percutaneous Coronary Intervention According to BMI.

OBJECTIVES

The aim of this study was to determine the prevalence and prognostic implications of elevated high-sensitivity C-reactive protein (hsCRP) in patients undergoing percutaneous coronary intervention (PCI) according to body mass index (BMI).

BACKGROUND

Whereas elevated hsCRP predicts adverse clinical outcome after PCI in the general population, the impact of BMI on its prognostic utility remains unclear.

METHODS

Data from 14,140 patients who underwent PCI between January 2009 and June 2017 at a large tertiary care center were analyzed. Patients were divided into 4 BMI categories: normal (BMI 18.5 to <25 kg/m

RESULTS

Elevated hsCRP was present in 18.9%, 23.6%, 33.3%, and 47.7% of the normal, overweight, obese, and severely obese groups, respectively. MACE rates were consistently higher in patients with elevated hsCRP across all BMI categories (normal, 13.4% vs. 8.3%; overweight, 11.2% vs. 7.2%; obese, 10.6% vs. 7.5%; severely obese, 11.9% vs. 6.5%; p < 0.01 for all). After multivariate adjustment, hsCRP elevation remained significantly associated with MACE independent of BMI (hazard ratios: normal, 1.43 [95% confidence interval: 1.04 to 1.95]; overweight, 1.56 [95% confidence interval: 1.21 to 1.88]; obese, 1.40 [95% confidence interval: 1.06 to 1.84]; severely obese, 1.92 [95% confidence interval: 1.35 to 2.75]; p < 0.05 for all).

CONCLUSIONS

Among patients undergoing PCI, the prevalence of hsCRP elevation progressively increased with higher BMI. Measurement of hsCRP facilitates prognostic risk assessment for adverse outcome after PCI across a broad range of BMI.

Informations de copyright

Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Author Disclosures Dr. Mehran has received institutional research grants from Abbott Laboratories, Abiomed, Applied Therapeutics, AstraZeneca, Bayer, Beth Israel Deaconess, Bristol Myers Squibb, CERC, Chiesi, Concept Medical, CSL Behring, DSI, Medtronic, Novartis Pharmaceuticals, and OrbusNeich; has received consultant fees from Abbott Laboratories, Boston Scientific, Janssen Scientific Affairs, Medscape/WebMD, Medtelligence (Janssen Scientific Affairs), Roivant Sciences, Sanofi, Siemens Medical Solutions; has received consultant fees paid to the institution from Abbott Laboratories, Bristol Myers Squibb; is an advisory board member and has received funding paid to the institution from Spectranetics/Philips/Volcano; holds equity (<1%) in Claret Medical and Elixir Medical; has received data and safety monitoring board membership fees paid to the institution from Watermark Research Partners; has performed consulting (no fee) for Idorsia Pharmaceuticals and Regeneron Pharmaceuticals; and is an associate editor for the American College of Cardiology and the American Medical Association. Dr. Mehran’s spouse is a consultant for Abiomed, The Medicines Company, and Merck. Dr. Dangas has received consulting fees or honoraria from AstraZeneca, Biosensors, Boston Scientific, and Medtronic; has received research grants to the institution from Biotronik, Abbott Laboratories; and has equity (entirely divested) in Medtronic. Dr. Baber has received speaker honoraria from AstraZeneca and Boston Scientific. Dr. Sharma has received consulting fees or honoraria from Abbott, Boston Scientific, Abiomed, and Cardiovascular Systems. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.