Author + information
- Carlos V. Serranoa,b,
- Fabiana Racheda,b,
- Fabio S. Brito Jr.a,b,
- Marcelo Katza,b,
- Cibele Garzilloa,b,
- Antonio Pesaroa,b,
- Teresa C.D.C. Nascimentoa,b,
- Michael E. Farkouha,b,
- Marco A. Perina,b and
- Roberto Kalil-Filhoa,b
Background: Percutaneous coronary intervention (PCI) is a prevalent approach for revascularization in patients with stable ischemic heart disease (SIHD). However, the favorable results after a successful PCI may be diminished by the extent of postprocedural inflammatory response (PIR) and myocardial injury (PMI). Moreover, the impact of preprocedural non-high-density lipoprotein cholesterol (non-HDL-C), currently considered a main target for dyslipidemia management, on PIR and PMI is unclear.
Methods: We enrolled 718 consecutive SIHD patients who successfully underwent elective PCI and had preprocedural levels of non-HDL-C available. Patients were divided into the following groups: low non-HDL-C group (non-HDL-C<100 mg/dl, n=408) and high non-HDL-C group (non-HDL-C≥100 mg/dl, n=310). Blood samples were collected before and on a periodic basis after PCI, and the peak levels of high-sensitivity C-reactive protein (hsCRP), creatine phosphokinase MB isoenzyme (CKMB) and troponin I (TnI) were determined. Multiple linear regression analyses were performed to determine the association of non-HDL-C levels with the occurrence of postprocedural TnI, CKMB and hsCRP alterations.
Results: The baseline characteristics (gender, smoking status, previous MI, renal impairment, previous CABG, previous stroke and body mass index) were similar among the two groups. High non-HDL-C patients were younger, had lower prevalence of hypertension and insulin-dependent diabetes, and were less likely to receive statins. Postprocedural peaks of TnI and CKMB were similar between groups. Patients in both groups had increased postprocedural hsCRP levels but levels were greater in the high non-HDL-C patients [10.2 (0.3-239.1) vs. 7.2 (0-256.4) mg/dl; p=0.002]. Multiple linear regression analyses demonstrated that age, number of target lesions and non-HDL-C levels were independently associated with periprocedural variation of hsCRP.
Conclusions: In SIHD patients undergoing PCI, high preprocedural non-HDL-C levels were independently associated with an increased risk of postprocedural inflammatory response, and not with myocardial injury – regardless of previous use of statin.
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: 1166-332
- 2017 American College of Cardiology Foundation