The prognostic value of the change in the level of inflammatory markers in stable coronary artery patients with stent implanted

Abstract

Vascular inflammation has a pivotal role in the progression of atherosclerosis and major cardiovascular events (MACE). However, there is limited data concerning to role of changes in inflammatory markers in predicting MACE. In the current study, it was investigated whether the difference between high sensitive C-Reactive Protein (hs-CRP) and systemic immune-inflammatory index values (?hs CRP and ?SII) measured before and after the procedure and residual SYNTAX score (rSS) in stable coronary artery patients underwent percutaneous coronary intervention (PCI) could predict MACE. 203 patients (mean age: 62.11±9.20, 75% male) were included in the study. Before the first procedure and at the 1st month after the procedure(s), their blood was drawn. rSS was calculated. MACE was determined as cardiovascular mortality, target vessel revascularization non-fatal myocardial infarction, and ischemic stroke. MACE was observed in 20 patients (9.9%). Of these patients, 3 (1.5%) had cardiovascular mortality, 3 (1.5%) had a non-fatal myocardial infarction, 12 (5.9%) had target vessel revascularization due to unstable angina, and the remaining 2 (1.0%) had an ischemic stroke. The area under the curve (AUC) to predict MACE diagnosis was 0.548 for ?SII and 0.647 for ?hs-CRP and 0.766 for rSS. In multiple regression analysis, only rSS > 4 was an independent predictor for MACE (HR=3.41, 95% CI: 1.39-8.35, p=0.007). The change in SII and hs-CRP after PCI was found to be insufficient to predict MACE, while rSS was the only independent predictor for MACE.