Residual inflammatory risk at 12 months after acute coronary syndromes is frequent and associated with combined adverse events.

Details

Serval ID
serval:BIB_541186F9F92C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Residual inflammatory risk at 12 months after acute coronary syndromes is frequent and associated with combined adverse events.
Journal
Atherosclerosis
Author(s)
Klingenberg R., Aghlmandi S., Gencer B., Nanchen D., Räber L., Carballo D., Carballo S., Stähli B.E., Landmesser U., Rodondi N., Mach F., Windecker S., Bucher H.C., von Eckardstein A., Lüscher T.F., Matter C.M.
ISSN
1879-1484 (Electronic)
ISSN-L
0021-9150
Publication state
Published
Issued date
18/01/2021
Peer-reviewed
Oui
Volume
320
Pages
31-37
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Residual inflammatory risk (RIR) after acute coronary syndromes (ACS) may identify patients likely to benefit from anti-inflammatory therapies.
Patients from the Special Program University Medicine ACS cohort were divided into four groups according to level of hsCRP at baseline and after 12 months: persistently high RIR, increased RIR (first low, then high hsCRP), attenuated RIR (first high, then low hsCRP), or persistently low RIR. High RIR was defined as hsCRP ≥ 2 mg/L. An independently adjudicated incident of combined adverse events was defined as the composite of myocardial infarction, clinically indicated coronary revascularization or cerebrovascular events.
Among 1209 patients with available hsCRP, clinical and demographic data, 295 (24.4%) patients had persistently high RIR (delta hsCRP median (IQR): 2.3 (-9.9; 0.3) (mg/L) and 72 (5.96%) patients had increased RIR (delta hsCRP median (IQR): +2.45 (1.2; 8.35) (mg/L). A total of 390 (32.26%) patients had attenuated RIR (delta hsCRP median (IQR): 3.55 (-10; -2) (mg/L) and 452 (37.38%) patients had persistently low RIR (delta hsCRP median (IQR): 0.2 (-0.6; 0.1) (mg/L). Of 90 combined adverse events, 31 (10.5%) occurred in the persistently high (multivariable adjusted OR: 1.71, (95% CI 1.08-2.7), p = 0.022) compared with the three other groups combined (increased RIR: 3 (4.2%), attenuated RIR 30 (7.7%), persistently low RIR 26 (5.8%).
Persistently elevated hsCRP after ACS is found in a quarter of patients with the highest risk of combined adverse events. This underlines the need to perform anti-inflammatory intervention trials in RIR patients.
Keywords
Biomarkers, CRP, Inflammation, Myocardial infarction, Risk factors
Pubmed
Open Access
Yes
Create date
08/02/2021 13:39
Last modification date
11/06/2021 5:34
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