Prognostic Significance of High Sensitivity C-Reactive Protein before and after Percutaneous Coronary Intervention in Patients with Angina Pectoris

Background: Elevated high sensitivity C reactive protein (hs-CRP) has been identified as a strong predictor of prognosis in acute coronary syndrome. The prognostic significance of hs-CRP level in percutaneous coronary intervention (PCI) is unclear. Aim of the Work: Is to assess the hs-CRP value and its prognostic significance in short and long term follow-up after PCI. Methods: We prospectively studied 41 patients; 28 patients with chronic stable angina and 13 patients unstable angina, who underwent elective coronary stenting. All patients had normal troponin level before the procedure. Blood samples for hs-CRP were obtained before the procedure, 24 hours after the procedure and followed-up at 1 month and after 2 years. Results: Mean hs-CRP before and post procedure in all patients who underwent PCI was 2.38 ±2.21μg/ml and 7.43± 10.6μg/ml respectively. There was significant difference between pre procedural hs-CRP and 24 hours post procedural (p=0.007). At follow-up period (1 month), no major adverse cardiac events (MACE) have occurred. At follow-up period (2 years), MACE has occurred in 13 patients. There was a weak correlation between the level of the pre-procedural hsCRP and occurrence of MACE ( r=0.22, p=0.2) and no correlation between post procedural hs-CRP and occurrence of MACE was reported. Conclusion: Mechanical disruption of atherosclerotic plaque during elective coronary stent implantation causes a systemic inflammatory response. Measuring of hs-CRP either pre-procedural or post procedural in low risk patients is not useful for predicting of either early or late cardiovascular events.