Predictive Value of C-reactive Protein in Patients with Unstable Angina Pectoris Undergoing Coronary Artery Stent Implantation

Role of High-Sensitivity C-reactive Protein Levels in Predicting the Risk of Six-Month Event Rates in Patients With Chronic Stable Angina Undergoing Percutaneous Transluminal Coronary Angioplasty With a Drug-Eluting Stent

Introduction This prospective observational study reports the association between baseline high-sensitivity C-reactive protein (hs-CRP) levels and adverse events at six months in patients who were diagnosed with symptomatic chronic stable angina and then underwent percutaneous transluminal coronary angioplasty (PTCA) with a drug-eluting stent (DES). Methods A total of 104 patients were examined with chronic stable angina over a period of six months. Before conducting percutaneous coronary intervention (PCI), the baseline levels of hs-CRP were measured, and based on the levels, the patients were grouped into high and low hs-CRP groups. Results The primary causes of death or the need for repeat revascularization or myocardial infarction or angina were concluded after assessing the patients for six months. A total of 104 patients were studied, among which 72 (69.23%) had low hs-CRP and 32 (30.77%) had high hs-CRP levels. The number of males in this study was 68 (65.38%) and females were 36 (34.62%). The mean age of the patients was 55.26 ± 10.31 years. There were no significant differences among the groups in terms of gender, age, comorbidities, and risk factors except for certain predisposing factors like dyslipidemia and smoking. Moreover, we did not find any significant difference among the groups in the cause of death and myocardial infarction after a follow-up of six months. However, we observed a higher need for revascularization and angina outcomes in the group with high hs-CRP compared to low hs-CRP. Conclusion It can be concluded that a higher risk of angina and repeat revascularization is related to a high baseline hs-CRP but there is no evidence whether it is somehow linked to myocardial infarction and mortality or not.

The influence of complete coronary revascularization on long-term outcomes in patients with multivessel coronary heart disease undergoing successful percutaneous coronary intervention

The influence of complete revascularization (CR) compared with incomplete revascularization (ICR) on long-term outcomes was assessed in patients with multivessel coronary heart disease undergoing successful percutaneous coronary intervention (PCI). A retrospective analysis of the clinical data, lesion type and PCI data was carried out in 324 patients with multivessel coronary heart disease (CR group, 99 patients; ICR group, 225 patients). Major adverse cardiac events (MACE) were recorded at follow-up (mean +/- SD follow-up interval, 18 +/- 7.1 months). There were no significant differences in clinical characteristics between the two groups at follow-up, although the CR group showed a non-significant tendency to a higher incidence of non-fatal myocardial infarction, cardiac death, repeated revascularization and MACE compared with the ICR group. In conclusion, the long-term prognosis for ICR was not inferior to that for CR in patients with multivessel coronary heart disease undergoing successful PCI.

Restenosis related to percutaneous coronary intervention has been solved?

Percutaneous coronary intervention (PCI) has become the most important revascularization method in the treatment of coronary artery disease. The major problem in PCI has been renarrowing of the dilated vessel after the procedure (restenosis). The best results in the prevention of restenosis have been obtained by covering the stent with drugs that inhibit cellular growth, thus limiting excessive scar formation inside of the stent. With drug-eluting stents, restenosis has been reduced to one-tenth compared with balloon angioplasty and to one-fourth compared to bare metal stents. Due to drug-eluting stents, PCI is an alternative to bypass surgery. However, restenosis will remain a challenge due to the increased number of procedures and more difficult disease treated with PCI.