- NEWS . 16 Mar 2020
Coronary artery calcification and inflammation impact adverse cardiovascular events post-PCI
Patients with both coronary artery calcification (CAC) and systemic inflammation have an increased risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), according to results from a retrospective single-centre registry.
A total of 17,711 consecutive patients who underwent PCI in their hospital between 1 January 2009 and 31 December 2015 were included in the study. Patients were categorized according to the degree of CAC (moderate/severe vs none/mild) and high-sensitivity C-reactive protein (hsCRP) level (≥2 vs <2 mg/L). MACE was defined as death, myocardial infarction or target vessel revascularization that occurred over 1 year.
Patients with both moderate/severe CAC and elevated hsCRP (n=1,814 [10.2%]) were found to be older with more comorbid risk factors compared with those with moderate/severe CAC alone (n=1,687 [9.5%]), elevated hsCRP alone (n=7,597 [42.9%]) or neither abnormality (n=6,613 [37.3%]). The analogous 1-year MACE rates were 21.2%, 14.9%, 11.5% and 7.8%, respectively (p-trend <0.001). After multivariable adjustment, the results remained unchanged, which further suggests the synergistic adverse effects in patients with both CAC and elevated hsCRP.
In conclusion, the presence of both moderate/severe CAC and systemic inflammation confers a synergistic effect on the risk of MACE after PCI. Novel or more intense therapeutic interventions are warranted to mitigate risk in these patients.
Aoi S, et al. Combined and independent impact of coronary artery calcification and inflammation on risk for adverse cardiovascular events after percutaneous coronary intervention: Results from a large single-center registry. Catheter Cardiovasc Interv 2020. doi: 10.1002/ccd.28784. [Epub ahead of print]