Author + information
- Shunsuke Aoi,
- Usman Baber,
- Jason Kovacic,
- Roxana Mehran,
- Melissa Aquino,
- George Dangas,
- Joseph Sweeny,
- Pooja Vijay,
- Srushti Shah,
- Pedro Moreno,
- Annapoorna Kini and
- Samin Sharma
Introduction: Systemic inflammation and coronary artery calcification (CAC) are associated with increased risks for cardiovascular events after PCI. We sought to examine the impact of both, in isolation and in combination, on risks for major adverse cardiac events (MACE) in a large PCI cohort.
Method: We included 15,697 consecutive patients who underwent percutaneous coronary intervention (PCI) in our hospital between January 1, 2009 and December 31, 2014. Baseline characteristics and one-year outcomes were stratified in four mutually exclusive groups according to the degree of coronary calcification (moderate/severe vs. none/mild) and high-sensitivity C-reactive protein (hsCRP) level (above or below 2 mg/dl). MACE was defined as death, myocardial infarction, and target vessel revascularization (TVR) occurring over one year.
Results: Patients with both moderate/severe CAC and elevated hsCRP (n=1,559 [10.0%]) were older with more comorbid risk factors compared to those with moderate/severe CAC alone (n=1,420 [9.0%]), elevated hsCRP alone (n=6,850 [44.0%]) or neither abnormality (n=5,868 [37.0 %]). The analogous one-year MACE rates were 20.0%, 14.2%, 10.8% and 7.6% respectively (p<0.001). Results were unchanged after multivariable adjustment.
Conclusions: The presence of both systemic inflammation and moderate to severe CAC confer a synergistic effect on risk for MACE following PCI, indicating the need for novel or more intense therapeutic interventions to mitigate risk in such patients.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-331
- 2017 American College of Cardiology Foundation