• 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.

    Reference:
    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]