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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 Feb 13, 2019

Kosmidou I, et al. - Researchers assessed the impact of elevated baseline C-reactive protein (CRP) levels on the 3-year outcomes following left main coronary artery disease (LMCAD) revascularization as well as investigated for any possible impact of CRP on the relative outcomes of percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG) in the EXCEL trial, wherein randomized to PCI vs CABG was used to treat patients with LMCAD and Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) scores ≤32. Taking into account baseline CRP levels, they assessed the primary composite outcome of death, myocardial infarction (MI), or stroke. The median CRP was 3.10 mg/L (interquartile range 1.12-6.40 mg/L) among 999 patients with available CRP levels. According to findings, there was a strong association between elevated baseline CRP levels and subsequent death, MI, and stroke at 3 years in patients with LMCAD undergoing revascularization; this link was evident regardless of the mode of revascularization. A 3-fold higher risk of the 3-year primary end point was observed in patients with CRP ≥10 mg/L vs patients with lower CRP levels.
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