Baseline levels of serum high sensitivity C reactive protein and lipids in predicting the residual risk of cardiovascular events in Chinese population with stable coronary artery disease: a prospective cohort study

Abstract

BackgroundThe contributions of inflammation, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) to the residual risk of cardiovascular events have not been determined in a large cohort of Chinese population before. This study was aimed to investigate the association of serum levels of high sensitive C reactive protein (hs-CRP), TG and HDL-C with the residual risk of cardiovascular events in patients with stable coronary artery disease (CAD).MethodsWe enrolled 4090 patients with stable CAD from 13 hospitals in China. All participants received optimal medical treatment (OMT) for stable CAD suggested by guidelines and were followed. The endpoint measures were the first occurrence of a major adverse cardiovascular event (MACE), defined as cardiovascular death, non-fatal myocardial infarction, non-fatal stroke or unplanned coronary revascularization. Cox proportional regression analysis was conducted to identify independent predictors of MACE.ResultsWe found that hs-CRP and HDL-C levels were associated with coronary lesion severity at baseline (both p < 0.001). After 3 months OMT, 91.2% (3730/4090) patients achieved the therapeutic goal for low density lipoprotein cholesterol (LDL-C) (< 1.8 mmoL/L). During a mean follow-up period of 39.5 months, 11.5% (471/4090) patients suffered MACE. In multivariate Cox proportional regression analysis, the hazard ratio for MACE was 1.17 (95% confidence interval: 1.07–1.28, p < 0.001) per standardized deviation in the log-transformed hs-CRP levels after adjustment for other traditional cardiovascular risk factors. However, baseline TG and HDL-C levels were not associated with MACE in this study.ConclusionsBaseline hs-CRP level was an independent predictor of residual risk of cardiovascular events in Chinese population with stable CAD. However, TG and HDL-C levels were not associated with MACE.

Single Nucleotide Polymorphism rs17173608 in the Chemerin Encoding Gene: Is It a Predictor of Insulin Resistance and Severity of Coronary Artery Disease in Non-Obese Type 2 Diabetes?

“…Sulphonylureas are the second-line drugs in T2D management, and the use is associated with an adverse vascular function, which results in endothelial dysfunction and cardiovascular events [ 39 ]. SNP rs17173608 was associated with insulin resistance in our study and previous studies [ 36 ]. Besides this, RARRES2 SNP rs17173608 was associated with the severity of CAD in the study by Lachine et al [ 40 ].…”

“…In a previous study, CAD patients had higher hs–CRP, HDL-c, and total cholesterol levels, which were comparable to the findings of our study. [ 36 ]. rs17173608 is a RARRES2 gene variant, and to the best of our knowledge, this is the first study to associate rs17173608 with demographic and clinical factors of insulin resistance and severity of CAD.…”

Side Effects of Coronary Stenting such as Severe Coronary Stenosis and Multiple Coronary Chronic Total Occlusions in Elderly Patients via Induced Proinflammatory and Prooxidative Stress

“…MDA promoted the expression of proinflammatory cytokines and played an important role in atherosclerotic lesion development [10]. Hs-CRP was an inflammatory cardiovascular risk marker, and the pharmacologic inhibition of inflammatory response prevented major adverse cardiovascular events in patients with coronary heart disease [11]. In addition, hs-CRP was a marker for oxidative stress and was related to the risk of coronary in-stent restenosis in patients with coronary heart disease after coronary stenting [12].…”

“…MDA promoted the expression of proinflammatory cytokines and played an important role in atherosclerotic lesion development [10]. Hs-CRP was both an inflammatory marker and an oxidative stress marker and was related to coronary heart disease [11] and coronary in-stent restenosis in patients with coronary heart disease after coronary stenting [12]. Our results suggested that the side effects of coronary stenting such as severe coronary stenosis and multiple coronary chronic total occlusions in elderly patients was related to proinflammatory and prooxidative stress mediators.…”

“…MDA as a biomarker of atherosclerosis was detected in the serum and atherosclerotic lesions of arteries in patients with atherosclerosis and played a key role in atherosclerosis development and progression [10]. High-sensitivity C-reactive protein (hs-CRP) levels, the biomarkers of inflammatory response and oxidative stress response for assessing cardiovascular disease risk and coronary in-stent restenosis, were the independent predictors of future cardiovascular event risk, coronary atherosclerosis, coronary heart disease, and coronary restenosis [11–13].…”