RESUMO
The significance of the high-sensitivity C-reactive protein (hs-CRP) level in percutaneous coronary interventions (PCIs) is unclear. Troponin-T and hs-CRP levels were measured before PCI, after stenting, and 8 h, 24 h, and 30 days after the procedure in 68 consecutive patients who received bare-metal stents. The study endpoints were death, nonfatal myocardial infarction, and the need for revascularization. The mean follow-up time after PCI was 16.6 months. Patients who experienced an event had higher hs-CRP levels 24 h (P=.05) and 30 days (P< .02) after stenting. The area under the receiver operating characteristic (ROC) curve at 30 days had the highest sensitivity (i.e., 80%) and specificity (i.e., 72%) for predicting an event. The 12-month event-free survival rate (Kaplan-Meier) was greater when the hs-CRP level at 30 days was < or =2.5 mg/L than when it was above this value (P=.04). Consequently, measuring the hs-CRP level 30 days after stenting may be useful for predicting late events.
Assuntos
Proteína C-Reativa/análise , Stents/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Valor Preditivo dos Testes , Estudos Prospectivos , Desenho de Prótese , Sensibilidade e Especificidade , Fatores de TempoRESUMO
La proteína C reactiva de alta sensibilidad (PCR-as) tiene un valor incierto en el intervencionismo coronario percutáneo (ICP). En 68 pacientes consecutivos tratados con stents metálicos, se determinaron PCR-as y troponina T pre-ICP, post-stent, a las 8 h, a las 24 h y a los 30 días. Los objetivos finales fueron muerte, infarto de miocardio y nueva revascularización. El seguimiento medio post-ICP fue 16,6 meses. Los pacientes con eventos tuvieron PCR-as más alta a las 24 h (p = 0,05) y a los 30 días (p < 0,02). El área bajo la curva ROC de 30 días fue la más sensible (80%) y específica (72%) para predecir eventos. La supervivencia libre de eventos a los 12 meses fue superior cuando la PCR-as a los 30 días era <= 2,5 mg/l que cuando estuvo más elevada (p = 0,04). Por lo tanto, determinar PCR-as 30 días tras el ICP puede ser útil para predecir eventos tardíos
The significance of the high-sensitivity C-reactive protein (hs-CRP) level in percutaneous coronary interventions (PCIs) is unclear. Troponin-T and hs-CRP levels were measured before PCI, after stenting, and 8 h, 24 h, and 30 days after the procedure in 68 consecutive patients who received bare-metal stents. The study endpoints were death, nonfatal myocardial infarction, and the need for revascularization. The mean follow-up time after PCI was 16.6 months. Patients who experienced an event had higher hs-CRP levels 24 h (P=.05) and 30 days (P<.02) after stenting. The area under the receiver operating characteristic (ROC) curve at 30 days had the highest sensitivity (i.e., 80%) and specificity (i.e., 72%) for predicting an event. The 12-month event-free survival rate (Kaplan-Meier) was greater when the hs-CRP level at 30 days was <=2.5 mg/L than when it was above this value (P=.04). Consequently, measuring the hs-CRP level 30 days after stenting may be useful for predicting late events