Relation of Soft Plaque and Elevated Preprocedural High-Sensitivity C-Reactive Protein Levels to Incidence of In-Stent Restenosis After Successful Coronary Artery Stenting

Objectives To determine the association of pre- and postinterventional serum levels of interleukin-6 and high-sensitivity C-reactive protein at the six-month evaluation of restenosis after stenting of the femoropopliteal artery. Methods Sixty-eight consecutive patients with steno-occlusive femoropopliteal artery disease of Rutherford category III or IV who underwent stent implantation were included. Six-month patency was evaluated with color-coded duplex ultrasound. The association of in-stent restenosis with interleukin-6 and high-sensitivity C-reactive protein levels at baseline, and 24-h postintervention was assessed with a multivariate logistic regression analysis. Results In-stent restenosis was found in 15 patients (22.1%) within six months. Interleukin-6 and high-sensitivity C-reactive protein levels were significantly increased at 24-h postintervention compared to their preintervention values ( p < 0.001 and p = 0.002, respectively). Interleukin-6 values at baseline (odds ratio, 1.11; 95% confidence interval: 1.00, 1.23; p = 0.044) and 24-h postintervention (odds ratio, 1.04; 95% confidence interval: 1.02, 1.06; p < 0.001) were independently associated with six-month in-stent restenosis. Twenty-four-hour postinterventional high-sensitivity C-reactive protein levels were also found to be related to restenosis (odds ratio, 1.15; 95% confidence interval: 1.04, 1.26; p = 0.006), but high-sensitivity C-reactive protein levels at baseline did not show an independent association with in-stent restenosis (odds ratio, 0.57; 95% confidence interval: 0.35, 1.80; p = 0.667). Smoking, diabetes mellitus, and cumulative stent length were other parameters associated with an increased risk for in-stent restenosis. Conclusions Femoropopliteal artery angioplasty with stent placement induces an inflammatory response. Interleukin-6 is a powerful independent predictor of intermediate-term outcomes for stenting of the femoropopliteal artery, suggesting that its predictive value may be superior to that of high-sensitivity C-reactive protein.

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Prognostic Impact of 9-Month High-Sensitivity C-Reactive Protein Levels on Long-Term Clinical Outcomes and In-Stent Restenosis in Patients at 9 Months after Drug-Eluting Stent Implantation

PLoS ONE ◽

10.1371/journal.pone.0138512 ◽

2015 ◽

Vol 10 (9) ◽

pp. e0138512 ◽

Cited By ~ 7

Author(s):

I-Chang Hsieh ◽

Chun-Chi Chen ◽

Ming-Jer Hsieh ◽

Chia-Hung Yang ◽

Dong-Yi Chen ◽

...

Keyword(s):

High Sensitivity ◽

Drug Eluting Stent ◽

Prognostic Impact ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Stent Restenosis ◽

Drug Eluting ◽

In Stent Restenosis

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Elevated Preprocedural High-Sensitivity C-Reactive Protein Levels are Associated With Neointimal Hyperplasia and Restenosis Development After Successful Coronary Artery Stenting

Circulation Journal ◽

10.1253/circj.69.1477 ◽

2005 ◽

Vol 69 (12) ◽

pp. 1477-1483 ◽

Cited By ~ 26

Author(s):

Young Joon Hong ◽

Myung Ho Jeong ◽

Sang Yup Lim ◽

Sang Rok Lee ◽

Kye Hun Kim ◽

...

Keyword(s):

Coronary Artery ◽

Neointimal Hyperplasia ◽

High Sensitivity ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Coronary Artery Stenting

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High Sensitivity C-reactive Protein in Patients with Coronary Artery in-stent Restenosis: A Case-control Study

The Open Cardiovascular Medicine Journal ◽

10.2174/1874192402115010029 ◽

2021 ◽

Vol 15 (1) ◽

pp. 29-37

Author(s):

Hussein M. Ismail ◽

Ahmed O. Abaza ◽

Gamela M. Nasr ◽

Hesham Hegazy

Keyword(s):

Coronary Artery ◽

Case Control Study ◽

High Sensitivity ◽

Control Group ◽

C Reactive Protein ◽

Reactive Protein ◽

Stent Restenosis ◽

The Mean ◽

Serial Measurements ◽

Control Study

Background: Inflammation plays a pivotal role in the pathogenesis of In-Stent Restenosis (ISR). High sensitivity C-reactive protein (hsCRP) is positively associated with major cardiovascular events. Aim: We aimed to investigate the hsCRP inflammatory response to Percutaneous Coronary Intervention (PCI) in Coronary Artery Disease (CAD) patients with coronary ISR vs. patients without ISR. Methods: This case-control study included 80 CAD patients previously treated with drug-eluting stent (DES) implantation. Patients had Coronary Angiography (CAG) because of chest pain or equivalent symptoms and were subdivided into 2 groups. Group A (n=40) included CAD patients with ISR. Group B (n=40) included age and gender-matched controls with CAD but without ISR. Serum hsCRP levels were obtained before PCI (baseline) and 8, 16, 24 h post-PCI. Results: At baseline (before intervention/CAG), the hsCRP level was increased in the ISR group compared with the No-ISR group (p=0.007). There were 36 (90%) patients in the ISR group who had a high hsCRP (>3 mg/L) compared with 25 (62.5%) patients in the No-ISR group. Also, there was a significant relationship between high hsCRP and the ISR. Patients with ISR had higher frequencies and percentages of elevated CRP than the no-ISR control group. This difference was maintained for all measurements, baseline, after 8, 16, and 24 h (p<0.05). Repeated measures analysis of variance (ANOVA) in the ISR group revealed that mean hsCRP differed significantly between serial measurements (p<0.001). In contrast, in the control group, the mean hsCRP did not differ significantly between the serial measurements (p=0.65). Most of our patients (n=66, 82.5%) had 1-vessel CAD disease, and the left anterior descending (LAD) coronary artery was significantly affected in 46 patients (57.5%). Management of restenosis was accomplished mainly by stenting by DES in 29 patients (72.5%). Conclusion: Patients with ISR had substantially higher pre- and post-PCI hsCRP levels than the no-ISR controls. This difference was maintained up to 24h post-PCI. Conversely, the mean hsCRP did not significantly differ at the follow-up points for the controls without ISR.

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