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Prevalence and prognostic impact of hsCRP elevation are age‐dependent in women but not in men undergoing percutaneous coronary intervention
Author(s) -
Blum Moritz,
Cao Davide,
Chandiramani Rishi,
Goel Ridhima,
Roumeliotis Anastasios,
Sartori Samantha,
Beyhoff Niklas,
Kelle Sebastian,
Kovacic Jason C,
Krishnan Prakash,
Sweeny Joseph,
Barman Nitin,
Baber Usman,
Dangas George D.,
Kini Annapoorna,
Sharma Samin K.,
Mehran Roxana
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29402
Subject(s) - medicine , mace , percutaneous coronary intervention , conventional pci , myocardial infarction , quartile , cardiology , population , st elevation , confidence interval , environmental health
Background High‐sensitivity C‐reactive protein (hsCRP) predicts outcomes after percutaneous coronary intervention (PCI). Objective We studied the prevalence and prognostic impact of hsCRP elevation according to age in men and women undergoing PCI. Methods We included patients undergoing PCI at our center from 2010 until 2017, excluding those with myocardial infarction (MI) on presentation, neoplastic disease and hsCRP >10 mg/L at baseline. Elevated hsCRP was defined as >3 mg/L. The outcome of interest was major adverse cardiac events (MACE) consisting of all‐cause death, MI and target vessel revascularization. The association between hsCRP elevation and outcomes was assessed using adjusted Cox models. Results 10,432 men and 4,345 women were included. Elevation of hsCRP was present in 25.7% of men and 37.0% of women ( p < .01). In men, prevalence of hsCRP elevation was stable across age strata ( p trend = .42). In women, hsCRP elevation was most prevalent in patients <50 years (44.6%) and decreased stepwise with increasing age ( p trend < .001). After stratifying the population into age quartiles (Q1: <59 years, Q2: 59–66 years, Q3: 67–74 years, Q4: ≥75 years), hsCRP elevation was associated with increased risk of MACE across all age groups in men (HR [95% CI] Q1: 1.49 [1.12–1.98]; Q2: 1.51 [1.21–2.06]; Q3: 1.76 [1.27–2.51]; Q4: 1.43[1.03–1.97]). In women, hsCRP elevation was associated with increased risk of MACE only among older patients (HR [95% CI] Q1: 1.08 [0.64–0.82]; Q2: 1.52 [0.93–2.46]; Q3: 1.65 [1.08–2.50]; Q4: 1.52 [1.02–1.28]). Conclusion Among patients undergoing PCI, prevalence and prognostic value of hsCRP elevation were age‐dependent exclusively in women.