A persistent increase in C-reactive protein is a risk factor for restenosis in patients with stable angina who are not receiving statins

Hoshida, Shiro; Nishino, Masami; Takeda, Toshihiro; Tanouchi, Jun; Yamada, Yoshio; Hori, Masatsugu

doi:10.1016/j.atherosclerosis.2003.12.017

Cited by 20 publications

(15 citation statements)

References 24 publications

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“…CRP protein levels have been shown to be persistently higher at 6 months in those patients with ISR in some studies (50) but not in others (51), thus suggesting that baseline or post-procedural levels of CRP may help in prediction of ISR more than that at follow-up.…”

Section: Prognostic Value Of Inflammatory Biomarkers With Bmsmentioning

confidence: 97%

“…3). Of interest, Hoshida et al (50) demonstrated that in patients with stable angina, increased pre-procedural CRP levels were an important risk factor for ISR only among patients who were not receiving statins, but not among treated patients. Accordingly, Walter et al (53) showed an interaction among admission CRP levels, statin therapy, and rate of restenosis in patients undergoing BMS implantation.…”

Section: Prognostic Value Of Inflammatory Biomarkers With Bmsmentioning

confidence: 98%

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The Evolving Role of Inflammatory Biomarkers in Risk Assessment After Stent Implantation

Niccoli

Montone

Ferrante

et al. 2010

Journal of the American College of Cardiology

105

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The main adverse reactions to coronary stents are in-stent restenosis (ISR) and stent thrombosis. Along with procedural factors, individual susceptibility to these events plays an important role. In particular, inflammatory status, as assessed by C-reactive protein levels, predicts the risk of ISR after bare-metal stent implantation, although it does not predict the risk of stent thrombosis. Conversely, C-reactive protein levels fail to predict the risk of ISR after drug-eluting stent (DES) implantation, although they appear to predict the risk of stent thrombosis. Of note, DES have abated ISR rates occurring in the classical 1-year window, but new concern is emerging regarding late restenosis and thrombosis. The pathogenesis of these late events seems to be related to delayed healing and allergic reactions to polymers, a process in which eosinophils seem to play an important role by enhancing restenosis and thrombosis. The identification of high-risk individuals based on biomarker assessment may be important for the management of patients receiving stent implantation. In this report, we review the evolving role of inflammatory biomarkers in predicting the risk of ISR and stent thrombosis.

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Section: Prognostic Value Of Inflammatory Biomarkers With Bmsmentioning

confidence: 97%

Section: Prognostic Value Of Inflammatory Biomarkers With Bmsmentioning

confidence: 98%

The Evolving Role of Inflammatory Biomarkers in Risk Assessment After Stent Implantation

Niccoli

Montone

Ferrante

et al. 2010

Journal of the American College of Cardiology

105

View full text Add to dashboard Cite

show abstract

“…Therefore, we believe that preprocedural statin therapy can reduce thrombosis as an acute reaction after stent implantation in patients with stable angina. 20 To our knowledge, this is the first report showing that statins have an antithrombotic effect after stent implantation, using ISR tissue retrieved from patients undergoing DCA. Moreover, in almost all of the previous pathological studies of coronary arteries after stent implantation in humans, the tissues analyzed were obtained at autopsy.…”

Section: Discussionmentioning

confidence: 99%

“…38 Moreover, our previous report also revealed that statins can reduce persistent inflammation after PCI in patients with stable angina. 20 There are few multicenter studies evaluating the effects of statin on stable angina or acute coronary syndrome in the Japanese population, so we must await future results of some ongoing Japanese studies. 39,40 However, many reports have revealed that the pleiotropic effects of statins may reflect a common mechanism for downregulation of thrombin-mediated events, in particular at the cellular level.…”

Section: Discussionmentioning

confidence: 99%

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Preprocedural Statin Administration can Reduce Thrombotic Reaction After Stent Implantation

Nishino

Hoshida²,

Kato

et al. 2008

Circ J

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Plasma urokinase antigen and C-reactive protein predict angina recurrence after coronary angioplasty

Parfyonova¹,

Алексеева²,

Плеханова³

et al. 2013

Heart Vessels

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This study evaluates the predictive value of several biochemical indices of the coagulation-fibrinolysis system, platelet function, and inflammatory state for angina recurrence after successful percutaneous transluminal coronary angioplasty (PTCA). We measured preprocedural and follow-up plasma levels of C-reactive protein (CRP), fibrinogen, and urokinase plasminogen activator antigen (uPA), plasminogen activator inhibitor-1 (PAI-1) activity, tissue plasminogen activator activity, and adenosine diphosphate-induced platelet aggregation in 53 patients with chronic stable angina who underwent successful elective PTCA of single hemodynamically significant lesions in coronary arteries. All patients were followed up for 12 months after PTCA. The Cox proportional hazards model was used to assess the association of variables with angina recurrence rate. At the end of the follow-up, 16 patients had angina recurrence. Among 36 clinical, biochemical, and angiographic variables, the duration of stable angina more than 12 months before PTCA (χ (2) = 5.73; P = 0.02, hazard ratio (HR) 3.7, 95 % confidence interval (CI) 1.26-10.6), high baseline levels of CRP (>7 mg/l) (χ (2) = 8.34; P = 0.004, HR 2.9, 95 % CI 1.4-5.9), uPA antigen baseline (>1 ng/ml) (χ (2) = 17.11; P = 0.0001, HR 11.5, 95 % CI 3.6-36.7) and 48 h after PTCA (χ (2) = 15.73; P = 0.0001, HR 8.8, 95 % CI 3.01-25.96), baseline PAI-1 activity (>18 IU/ml) (χ (2) = 9.37; P = 0.002, HR 7.6, 95 % CI 2.07-27.84) were significant predictors of recurrent angina by univariate analyses. According to stepwise multivariate analyses, only the levels of plasma uPA antigen and serum CRP were shown to be significant independent predictors of angina recurrence (multivariate uPA χ (2) = 8.22, P = 0.004, HR 6.2, 95 % CI 1.78-21.67; CRP χ (2) = 4.09, P = 0.04, HR 1.9, 95 % CI 1.02-3.68). High preprocedural plasma uPA and serum CRP levels are indicative of angina recurrence after successful PTCA, and are valuable for the prognosis of restenosis.

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A persistent increase in C-reactive protein is a risk factor for restenosis in patients with stable angina who are not receiving statins

Cited by 20 publications

References 24 publications

The Evolving Role of Inflammatory Biomarkers in Risk Assessment After Stent Implantation

The Evolving Role of Inflammatory Biomarkers in Risk Assessment After Stent Implantation

Preprocedural Statin Administration can Reduce Thrombotic Reaction After Stent Implantation

Plasma urokinase antigen and C-reactive protein predict angina recurrence after coronary angioplasty

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