Elevated Preprocedural High-Sensitivity C-Reactive Protein Levels are Associated With Neointimal Hyperplasia and Restenosis Development After Successful Coronary Artery Stenting

Young Joon Hong; Myung Ho Jeong; Sang Yup Lim; Sang Rok Lee; Kye Hun Kim; Il Suk Sohn; Hyung Wook Park; Ju Han Kim; Weon Kim; Youngkeun Ahn; Jeong Gwan Cho; Jong Chun Park; Jung Chaee Kang

doi:10.1253/circj.69.1477

Clinical Investigation

Elevated Preprocedural High-Sensitivity C-Reactive Protein Levels are Associated With Neointimal Hyperplasia and Restenosis Development After Successful Coronary Artery Stenting

Young Joon Hong, Myung Ho Jeong, Sang Yup Lim, Sang Rok Lee, Kye Hun Kim, Il Suk Sohn, Hyung Wook Park, Ju Han Kim, Weon Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang

Author information

Young Joon Hong
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Myung Ho Jeong
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Sang Yup Lim
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Sang Rok Lee
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Kye Hun Kim
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Il Suk Sohn
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Hyung Wook Park
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Ju Han Kim
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Weon Kim
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Youngkeun Ahn
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Jeong Gwan Cho
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Jong Chun Park
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Jung Chaee Kang
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences

Keywords: Inflammation, Restenosis, Stent

JOURNAL FREE ACCESS

2005 Volume 69 Issue 12 Pages 1477-1483

DOI https://doi.org/10.1253/circj.69.1477

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Abstract

Background Recent data indicate that an elevated serum level of high-sensitivity C-reactive protein (hs-CRP) predicts the risk of recurrent coronary events, and that statin therapy decreases the risk of coronary events. This study assessed the relationship between the pre-procedural hs-CRP level and in-stent neointimal hyperplasia (NIH) after stenting and the effects of statins on the relationship between restenosis after stenting and the serum hs-CRP levels of patients with coronary artery disease. Methods and Results This study included 100 patients who underwent stent implantation for angiographically significant stenosis. Patients were divided into a normal C-reactive protein (CRP) group (<0.5 mg/dl, n=59) and elevated CRP group (≥0.5 mg/dl, n=41). All patients underwent angiographic and intravascular ultrasound follow-up at 6 months. The baseline CRP level was 0.29±0.08 mg/dl in the normal CRP group and 2.90±2.31 mg/dl in the elevated CRP group. The NIH cross-sectional area (CSA) in the minimal lumen CSA at follow-up was significantly larger in the elevated CRP group compared with the normal CRP group (1.9±1.3 mm² vs 3.0±1.5 mm², p=0.001). A significant positive correlation was found between pre-interventional CRP level and NIH area (r=0.52, p<0.001). In patients with normal CRP, an association between statin therapy and restenosis was not observed. However, when the analysis was confined to patients with elevated CRP, statin therapy significantly reduced the restenosis rate (20% vs 37.5%, p=0.031). In the normal CRP group, the intra-stent neointimal area at 6 months was not different between the non-statin and statin groups (2.2±1.4 mm² vs 1.8±1.1 mm²). However, in the elevated CRP group, statin therapy significantly decreased the neointimal area at 6-month follow-up (3.6±1.7 mm² vs 2.4±1.3 mm², p<0.001). Conclusion Measuring the pre-interventional hs-CRP level may help predict the development of restenosis after stenting and statin therapy will significantly reduce the restenosis rate in patients with an elevated hs-CRP. (Circ J 2005; 69: 1477 - 1483)

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