C-reactive protein and prognosis after percutaneous coronary intervention and bypass graft surgery for left main coronary artery disease: Analysis from the EXCEL trial
American Heart Journal Jan 17, 2019
Kosmidou I, et al. - Researchers investigated how 3-year outcomes following left main coronary artery disease (LMCAD) revascularization were influenced by elevated baseline C-reactive protein (CRP) levels, and if CRP had any impact on the relative outcomes of percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG) in the EXCEL trial with patients with LMCAD and SYNTAX scores ≤32. CRP levels were available in 999 patients; median CRP was 3.10 mg/L (interquartile range 1.12 mg/L to 6.40 mg/L). Findings revealed that, regardless of the mode of revascularization, elevated baseline CRP levels were strongly related to subsequent death, myocardial infarction (MI) and stroke at 3 years. With greater baseline CRP levels, a steady increase was observed in the rate of the primary composite endpoint of death, MI or stroke at 3 years. A 3-fold higher risk of the 3-year primary endpoint was seen among patients with CRP ≥10 mg/L vs patients with lower CRP levels.
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