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Incremental prognostic value of high-sensitive C-reactive protein in patients undergoing coronary computed tomography angiography.

Abstract：

BACKGROUND:This study was performed to investigate whether combined use of high-sensitivity C-reactive protein (hs-CRP) levels and coronary computed tomography angiography (CCTA) results have additional prognostic value for predicting cardiovascular events in patients with suspected coronary artery disease (CAD). METHODS:A total of 445 patients (61.6±9.3 years and 62.9% men) with suspected CAD who underwent both CCTA and hs-CRP measurement within one month were evaluated. Information on cardiovascular events, including cardiac death, non-fatal myocardial infarction, unstable angina and late (≥six months after CCTA) coronary revascularization was assessed. RESULTS:One hundred and eighty-five patients (41.6%) had obstructive CAD on CCTA (stenosis ≥50%). Both high hs-CRP (≥2.25mg/L) and obstructive CAD were the independent predictors of cardiovascular events. Kaplan-Meier analysis showed that event rates were significantly different according to the presence of obstructive CAD and hs-CRP levels. Addition of hs-CRP levels to combined information of clinical factors and CCTA results further increased the predictive power for cardiovascular events (global chi-square ratio, from 13.51 to 19.14, p=0.022). Event risks were approximately 21.0-fold higher in the highest-risk group with both obstructive CAD and high hs-CRP levels than in the lowest-risk group with both insignificant CAD and low hs-CRP levels (p=0.007). CONCLUSIONS:Combined use of hs-CRP levels and CCTA results provided a significant improvement in prognostic power for cardiovascular events in patients with suspected CAD. hs-CRP measurement may be a simple and useful method for determining risk stratification and treatment strategy in patients undergoing CCTA.

journal_name

J Cardiol

journal_title

Journal of cardiology

authors

Seo WW,Kim HL,Kim YJ,Yoon YE,Lee SP,Kim HK,Cho GY,Zo JH,Choi DJ,Sohn DW

doi

10.1016/j.jjcc.2015.09.010

subject

Has Abstract

pub_date

2016-09-01 00:00:00

pages

222-8

issue

3

eissn

0914-5087

issn

1876-4738

pii

S0914-5087(15)00297-X

journal_volume

68

pub_type

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