C-reactive protein and prognosis in women and men with coronary artery disease after percutaneous coronary intervention |
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| Authors: | Gjin Ndrepepa Siegmund Braun Salvatore Cassese Massimiliano Fusaro Lamin King Adnan Kastrati Roland Schmidt |
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| Affiliation: | 1. Deutsches Herzzentrum München, Technische Universität, Lazarettstrasse 36, 80636, Munich, Germany;2. Krankenhaus Barmherzige Brüder, Munich, Germany;1. Research Institute, Fujimori Kogyo Co., Ltd., Yokohama, Kanagawa, Japan;2. Department of System Biology in Thromboregulation, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan;3. Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan;4. Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA;1. Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi City, Taiwan;2. Min-Hwei College of Health Care Management, Tainan, Taiwan;3. Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan;4. Department of Neurology, Landseed Hospital, Tao-Yuan County, Taiwan;5. Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan;6. Landseed Hospital, Tao-Yuan County, Taiwan;7. Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan;8. Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan;2. Department of Neurology, Abington Memorial Hospital, Abington, Pennsylvania;3. Department of Neurology, Brown University, Providence, Rhode Island;4. Department of Neurology, Columbia University, New York, New York;6. Department of Neurology, Robert Wood Johnson, New Brunswick, New Jersey;5. Department of Neurology, New Hanover Regional Medical Center, Wilmington, North Carolina;1. Department of Cardiovascular, Nefrologic, Anestesiologic and Geriatric Sciences, La Sapienza University, Italy;2. National Institute for Infectious Diseases IRCCS ‘L. Spallanzani’, Rome, Italy;3. Department of Biology, University of Rome ‘Tor Vergata’, Rome, Italy;4. Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, Lecce 73100, Italy |
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| Abstract: | ![]()
BackgroundSex-based differences in the association between C-reactive protein (CRP) and cardiovascular events in patients with coronary artery disease (CAD) are incompletely investigated. We investigated whether there are gender differences in the association between CRP and outcome in patients with CAD after percutaneous coronary intervention (PCI).MethodsThis study included 13,170 consecutive patients with CAD: 10,098 men and 3072 women. CRP was measured on admission in all patients. The primary outcome was 1-year mortality.ResultsCRP level (median [25th–75th percentiles]) was higher in women than in men (3.08 [1.30–8.37] mg/L vs 2.30 [0.92–6.47] mg/L; P < 0.001). CRP was > 3 mg/L in 4250 men (42.1%) and 1554 women (50.6%; P < 0.001). One-year mortality was 4.9% (n = 641 deaths). Deaths occurred in 318 men with CRP > 3 mg/L and 122 men with CRP ≤ 3 mg/L (mortality estimates 7.7% and 2.1%, P < 0.001) and in 154 women with CRP > 3 mg/L and 47 women with CRP ≤ 3 mg/L (mortality estimates 10.1% and 3.2%, P < 0.001). After adjustment in the Cox model, CRP was associated with increased risk of mortality in women (adjusted hazard ratio [HR] = 1.03, 95% confidence interval [CI] 1.01–1.04, P < 0.001 for each 5 mg/L increase) and in men (adjusted HR = 1.02 [1.01–1.03], P < 0.001, for each 5 mg/L increase). CRP predicted mortality with an area under the receiver-operating characteristic curve = 0.721, [0.683–0.760] in women and 0.732, [0.707–0.757] in men (P = 0.659).ConclusionsElevated CRP levels provide similar prognostic information in men and women with CAD after PCI which is independent and supplementary to that provided by conventional cardiovascular risk factors. |
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