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- Title
Impact of C-Reactive Protein on In-Stent Restenosis.
- Authors
Jian-Jun Li; Yi Ren; Ke-Ji Chen; Alan C. Yeung; Bo Xu; Xin-Min Ruan; Yue-Jin Yang; Ji-Lin Chen; Run-Lin Gao
- Abstract
We sought to evaluate the impact of C-reactive protein (CRP) levels on in-stent restenosis after percutaneous coronary intervention. The plasma level of CRP is considered a risk predictor for cardiovascular diseases. However, the relationship between CRP and in-stent restenosis has been a matter of controversy. Meta-analysis reduces variability and better evaluates the correlation. We performed a systemic search for literature published in March 2008 and earlier, using MEDLINE®, the Cochrane clinical trials database, and EMBASE®. We also scanned relevant reference lists and hand-searched all review articles or abstracts from conference reports on this topic. Of the 245 studies that we initially searched, we chose 9 prospective observational studies (1,062 patients). Overall, CRP concentration was higher in patients who experienced in-stent restenosis. The weighted mean difference in CRP levels between the patients with in-stent restenosis and those without was 1.67, and the Z-score for overall effect was 2.12 (P=0.03). Our subgroup analysis that compared patients with stable and unstable angina showed a weighted mean difference in the CRP levels of 2.22 between the patients with and without in-stent restenosis, and the Z-score for overall effect was 2.23 (P=0.03) in 5 studies of unstable angina patients. There was no significance in 4 studies of stable-angina patients. In spite of significant heterogeneity across the studies, our meta-analysis suggests that preprocedurally elevated levels of CRP are associated with greater in-stent restenosis after stenting and that this impact appears more prominent in unstable-angina patients.
- Subjects
C-reactive protein; BIOMARKERS; CORONARY restenosis; SURGICAL stents; CORONARY disease; CARDIOVASCULAR diseases; ANGINA pectoris; SYSTEMATIC reviews
- Publication
Texas Heart Institute Journal, 2010, Vol 37, Issue 1, p49
- ISSN
1526-6702
- Publication type
Article