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Role of Pre-procedural C-reactive Protein Level in the Prediction of Major Adverse Cardiac Events in Patients Undergoing Percutaneous Coronary Intervention: a Meta-analysisof Longitudinal Studies

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Abstract

Numerous studies have reported the relation between pre-procedural C-reactive protein (CRP) levels and the risk of major adverse cardiac events (MACEs) in patients undergoing percutaneous coronary intervention (PCI). However, the results across the studies were inconsistent. The aim of this study was to evaluate the predictive effect of pre-procedural CRP levels and the risk of MACEs in patients undergoing PCI. Longitudinal studies on the association between pre-procedural CRP levels and MACEs were identified by electronic and manual searches. Summary risk ratios (RRs) and 95 % confidence intervals (CI) were calculated employing an inverse variance random-effects model irrespective of between-study heterogeneity. Thirty-three studies involving 34,367 patients with 4119 MACEs were included in this study. High CRP level was associated with increased incidences of MACEs, all-cause death, myocardial infarction, coronary revascularization, and clinical restenosis, with pooled RRs of 1.97 (95 % CI, 1.65, 2.35), 2.88 (95 % CI, 2.15, 3.86), 1.81 (95 % CI, 1.48, 2.21), 1.31 (95 % CI, 1.11, 1.56), and 1.45 (95 % CI, 1.07, 1.96), respectively. Dose-response analysis showed that every 1 mg/L increment in pre-procedural serum CRP level was associated with a significant 12 % increase in the risk of MACEs. In spite of heterogeneity across the included studies, this meta-analysis suggests that pre-procedural serum CRP level is a valuable predictor of MACEs in patients undergoing PCI.

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Acknowledgments

We thank Dr. Jing Deng for helping us to perform some professional statistics.

Funding

This study was funded by the Guangdong Province Natural Science Fund (S2011010002650), Guangdong Provincial Science and Technology Projects (No. 2012B031800293), PhD Start-up program of Guangdong Province Natural Science Fund (S2012040008047), and National Natural Science Foundation of China (No. 81301676).

Conflict of Interest

We have no conflict of interests to disclose.

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Authors and Affiliations

  1. Department of Cardiology, Shahid Gangalal National Heart Center, Kathmandu, Nepal

    Singh-baniya Bibek

  2. Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 West Yanjiang Road, Guangzhou, 510120, China

    Yong Xie, Jia-jia Gao, Jing-feng Wang & Deng-feng Geng

  3. Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Guangzhou, 510120, China

    Zhi Wang

  4. Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-sen University, Guangzhou, 510120, China

    Yong Xie, Jia-jia Gao, Jing-feng Wang & Deng-feng Geng

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Correspondence to Jing-feng Wang or Deng-feng Geng.

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Singh-baniya Bibek, Yong Xie, and Jia-jia Gao contributed equally to this work.

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Bibek, Sb., Xie, Y., Gao, Jj. et al. Role of Pre-procedural C-reactive Protein Level in the Prediction of Major Adverse Cardiac Events in Patients Undergoing Percutaneous Coronary Intervention: a Meta-analysisof Longitudinal Studies. Inflammation 38, 159–169 (2015). https://doi.org/10.1007/s10753-014-0018-8

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