Inflammation during acute coronary syndromes - Risk of cardiovascular events and bleeding.

Details

Serval ID
serval:BIB_9699DC499E74
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Inflammation during acute coronary syndromes - Risk of cardiovascular events and bleeding.
Journal
International journal of cardiology
Author(s)
Nanchen D., Klingenberg R., Gencer B., Räber L., Carballo D., von Eckardstein A., Windecker S., Rodondi N., Lüscher T.F., Mach F., Muller O., Matter C.M.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Publication state
Published
Issued date
15/07/2019
Peer-reviewed
Oui
Volume
287
Pages
13-18
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Many parameters can affect the level of inflammation during acute coronary syndromes (ACS). We aimed to assess the one-year risk of major adverse cardiovascular events (MACE) and bleeding associated with elevated hsCRP levels during ACS, taking into account the severity of myocardial infarction, the timing of blood sampling and established long-term prognostic factors.
We studied 1864 consecutive patients with ACS enrolled in a contemporary multicenter prospective cohort study in Switzerland. HsCRP levels were determined at hospital admission. One year after discharge MACE and bleeding events were assessed. Multivariable adjusted Cox proportional hazards were computed with age, sex, time from symptom onset to blood draw, body mass index, current smoking, hypertension, diabetes mellitus, pre-existing cardiovascular disease, history of inflammatory disease, LDL-cholesterol levels, type of ACS, left ventricular ejection fraction and GRACE 1.0 risk score.
At one-year follow-up, 151 (8.1%) patients suffered MACE. Compared to patients with hsCRP below 2 mg/l, the risk of MACE was higher in patients with hsCRP levels between 2 and 5 mg/l, with a multivariate adjusted hazard ratio (HR) of 1.63 (95% confidence interval (CI) 0.93-2.84), in those with levels between 5 and 10 mg/l, with a HR of 2.80 (95% CI 1.58-4.96), and in those with levels above 10 mg/l, with a HR of 2.23 (95% CI 1.28-3.88). There was no difference in bleeding risk between the four groups.
Systemic inflammation in the acute phase of myocardial infarction is an independent predictor for cardiovascular events, but not for bleeding.
Keywords
Acute Coronary Syndrome/complications, Acute Coronary Syndrome/diagnosis, Acute Coronary Syndrome/drug therapy, Aged, Anti-Inflammatory Agents/adverse effects, Anti-Inflammatory Agents/therapeutic use, Biomarkers/blood, C-Reactive Protein/metabolism, Female, Follow-Up Studies, Hemorrhage/blood, Hemorrhage/chemically induced, Hemorrhage/epidemiology, Humans, Incidence, Inflammation/blood, Inflammation/etiology, Inflammation/prevention & control, Male, Prognosis, Prospective Studies, Switzerland/epidemiology, Acute coronary syndromes, HsCRP, Inflammation, Prevention
Pubmed
Web of science
Create date
05/05/2019 14:24
Last modification date
05/04/2020 5:20
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