Predischarge C-reactive protein and 1-year outcome after acute coronary syndromes |
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Authors: | Steg Philippe Gabriel,Ravaud Philippe,Tedgui Alain,Puel Jacques,Moyse Dominique,Curaudeau Emmanuelle,Quentzel Steven W ELISCOR Investigators |
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Affiliation: | a Department of Cardiology, Hôpital Bichat, Paris, France b Department of Epidemiology, Biostatistics, and Clinical Research, Hôpital Bichat, Paris, France c INSERM U-541, Hôpital Lariboisière, Paris, France d Department of Cardiology, Hôpital Rangueil, Toulouse, France e Consultant in Biostatistics, Paris, France f Department of Biostatistics, Bristol-Myers Squibb, Rueil-Malmaison, France g Cardiovascular Department, Bristol-Myers Squibb, Rueil-Malmaison, France. |
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Abstract: | PurposeTo investigate the relationship between high-sensitivity C-reactive protein and cardiovascular events following acute coronary syndrome.MethodsThis nationwide, cross-sectional, prospective study involved 439 patients with an acute coronary syndrome who presented to the hospital within 24 hours of symptom onset. Patients with a concomitant inflammatory process were excluded. Predischarge C-reactive protein samples were measured using a high-sensitivity method in a core laboratory. The outcome was the composite of death, acute myocardial infarction, stroke/transient ischemic attack, urgent hospitalization for unstable angina, and urgent revascularization within 1 year.ResultsAt 1 year, event rates were 10.2% for the lowest, 8.2% for the middle, and 11.0% for the highest C-reactive protein tertiles (P = .75) with similar event-free survival (P = .70). The hazard ratio (HR) for event rates between the highest and lowest tertiles was 1.10 (95% confidence interval [CI]: 0.54 to 2.20) There was marked overlap of C-reactive protein values between patients with and without events (median [interquartile range]: 8.39 [3.27 to 32.63] vs 9.55 [4.07 to 24.02], respectively; P = .91). C-reactive protein was not an independent predictor of 1-year events (HR for highest tertile: 1.19; 95% CI: 0.58 to 2.43; P = .64) and performed poorly on receiver operating characteristic curve analysis (C statistic = 0.51).ConclusionPredischarge high-sensitivity C-reactive protein level is a poor predictor of cardiovascular events at 1 year after acute coronary syndrome. |
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Keywords: | High-sensitivity C-reactive protein Acute coronary syndromes Cardiovascular events Outcomes |
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