POLYVASCULAR atherosclerotic disease (PolyVD) and elevated high-sensitivity C-reactive protein (hsCRP) levels are associated with a higher risk of adverse cardiovascular events following percutaneous coronary intervention (PCI). Recent research investigated the interaction between PolyVD and hsCRP levels, and their combined impact on clinical outcomes after PCI. Understanding these interactions could inform more targeted therapeutic approaches to improve patient prognosis.
The study analysed data from 10,359 patients undergoing PCI for treatment of chronic coronary disease at a tertiary centre between January 2012 and February 2020. PolyVD was identified by a history of cerebrovascular or peripheral artery disease in 17.4% of participants. Elevated hsCRP levels, classified as a baseline concentration over 3 mg/L, were more common in the PolyVD group (33.6%) compared to the non-PolyVD group (24.7%). At the 1-year follow-up, patients with both PolyVD and elevated hsCRP levels experienced significantly higher rates of adverse events than other subgroups, indicating that there is a combined impact of PolyVD and elevated hsCRP on Moreover, elevated hsCRP was independently associated with MACE within the PolyVD population, a relationship not observed in individuals without PolyVD.
The findings indicate that residual inflammatory risk significantly contributes to adverse outcomes post-PCI in patients with PolyVD. This highlights the need for targeted anti-inflammatory treatments in this high-risk group to potentially reduce the incidence of major adverse cardiovascular events. Future research should focus on the development of anti-inflammatory strategies, as well as further exploring the mechanisms linking inflammation and polyvascular disease to adverse cardiovascular outcomes.
Katrina Thornber, EMJ
Reference
Bay B et al. Inflammatory risk and clinical outcomes according to polyvascular atherosclerotic disease status in patients undergoing PCI. Clin Res Cardiol. 2024;DOI:10.1007/s00392-024-02471-w.
