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      Independent and Combined Effects of Serum Albumin and C-Reactive Protein on Long-Term Outcomes of Patients Undergoing Percutaneous Coronary Intervention.

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          Abstract

          Both inflammation and malnutrition have been reported to be closely linked to atherosclerosis, especially in patients with chronic kidney disease (CKD). The combined effects of serum albumin and C-reactive protein (CRP) on clinical outcomes after percutaneous coronary intervention (PCI) were investigated.Methods and Results:A total of 2,164 all-comer patients with coronary artery disease who underwent their first PCI and had data available for preprocedural serum albumin and hs-CRP levels between 2000 and 2011 were studied. Patients were assigned to 4 groups according to their median serum albumin and CRP levels (4.1 g/dL and 0.10 mg/dL, respectively). The incidence of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction (MI), was evaluated. During a median follow-up period of 7.5 years, 331 cases of MACE (15.3%), including 270 deaths and 61 non-fatal MIs, occurred. Kaplan-Meier curves showed that the rates of MACE differed significantly among the groups (log-rank P<0.0001), even stratified by with or without CKD (both log-rank P<0.0001). After adjustment for established cardiovascular risk factors, low serum albumin with high CRP levels was associated with adverse cardiac events (hazard ratio 2.55, 95% confidence interval 1.72-3,88, P<0.0001, high albumin/low CRP group as reference).

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          Author and article information

          Journal
          Circ. J.
          Circulation journal : official journal of the Japanese Circulation Society
          Japanese Circulation Society
          1347-4820
          1346-9843
          Aug 25 2017
          : 81
          : 9
          Affiliations
          [1 ] Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine.
          [2 ] Department of Cardiovascular Medicine, Juntendo University Urayasu Hospital.
          [3 ] Department of Cardiology, Juntendo University Shizuoka Hospital.
          Article
          10.1253/circj.CJ-17-0124
          28428450
          5162154b-232e-4b29-a016-af4635fbfa3d
          History

          Nutrition,Percutaneous coronary intervention,Coronary artery disease,Atherosclerosis,Inflammation

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