Residual Inflammatory Risk and its Association With Events in East Asian Patients After Coronary Intervention.
JACC Asia
; 2(3): 323-337, 2022 Jun.
Article
in En
| MEDLINE
| ID: mdl-36338415
ABSTRACT
Background:
East Asian population has a low level of inflammation compared with Western population. The prognostic implication of residual inflammatory risk (RIR) remains uncertain in East Asians.Objectives:
This study sought to provide an analysis to estimate early-determined RIR and its association with clinical outcomes in East Asian patients with coronary artery disease (CAD).Methods:
In an East Asian registry including patients with CAD undergoing percutaneous coronary intervention (PCI) (n = 4,562), RIR status was determined by measuring high-sensitivity C-reactive protein (hsCRP) serially at admission and at 1-month follow-up. Patients were stratified into 4 groups according to hsCRP criteria (≥2 mg/L) 1) persistent low RIR (lowon admission-low1 month 51.0%); 2) fortified RIR (lowon admission-high 1 month 10.3%); 3) attenuated RIR (highon admission-low1 month 20.5%); and 4) persistent high RIR (highon admission-high1 month 18.3%). The risks of all-cause death, ischemic events, and major bleeding were evaluated.Results:
In our cohort, median levels of hsCRP were significantly decreased over time (1.3 to 0.9 mg/L; P < 0.001). Compared with hsCRP on admission, hsCRP at 1 month showed the greater associations with all-cause death and ischemic event. During clinical follow-up, risks of clinical events were significantly different across the groups (log-rank test, P < 0.001). Compared with other RIR groups, persistent high RIR showed the higher risk for all-cause death (HRadjusted, 1.92; 95% CI 1.44 to 2.55; P < 0.001), ischemic events (HRadjusted, 1.26; 95% CI 1.02 to 1.56; P = 0.032), and major bleeding (HRadjusted, 1.98; 95% CI 1.30 to 2.99; P < 0.001), respectively.Conclusions:
Approximately one-fifth of East Asian patients with CAD have persistent high RIR, which shows the close association with occurrence of ischemic and bleeding events. (Gyeongsang National University Hospital Registry [GNUH]; NCT04650529).
AMI, acute myocardial infarction; ASCVD, atherosclerotic cardiovascular disease; C-reactive protein; CAD, coronary artery disease; CKD, chronic kidney disease; East Asian; LDL-C, low-density lipoprotein cholesterol; MACE, major adverse cardiovascular events; PCI, percutaneous coronary intervention; RIR, residual inflammatory risk; coronary artery disease; hsCRP, high sensitivity C-reactive protein; residual inflammation
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
JACC Asia
Year:
2022
Type:
Article
Affiliation country:
South Korea