Baseline high-sensitivity C-reactive protein and glycosylated hemoglobinA1c predict adverse outcomes in patients with chronic coronary syndromes undergoing percutaneous coronary intervention

Xiao-Fang Tang; De-Shan Yuan; Pei Zhu; Na Xu; Yi Yao; Pei-Zhi Wang; Yan Chen; Li-Jian Gao; Lei Song; Yue-Jin Yang; Run-Lin Gao; Xue-Yan Zhao; Jin-Qing Yuan

doi:10.1016/j.heliyon.2023.e23900

Baseline high-sensitivity C-reactive protein and glycosylated hemoglobinA1c predict adverse outcomes in patients with chronic coronary syndromes undergoing percutaneous coronary intervention

Heliyon. 2023 Dec 16;10(1):e23900. doi: 10.1016/j.heliyon.2023.e23900. eCollection 2024 Jan 15.

Authors

Xiao-Fang Tang¹, De-Shan Yuan¹, Pei Zhu¹, Na Xu¹, Yi Yao¹, Pei-Zhi Wang¹, Yan Chen¹, Li-Jian Gao¹, Lei Song¹, Yue-Jin Yang¹, Run-Lin Gao¹, Xue-Yan Zhao¹, Jin-Qing Yuan¹

Affiliation

¹ Department of Cardiology, Centre for Coronary Heart Disease, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Introduction: This study explored the ability of high-sensitivity C-reactive protein (hs-CRP) and glycosylated hemoglobin A1c (HbA1c) to predict adverse cardiac and cerebrovascular outcomes in patients with chronic coronary syndromes (CCS) undergoing percutaneous coronary intervention (PCI).

Methods: In total, 4083 consecutive patients with CCS undergoing PCI were investigated throughout 2013 at a single center. The primary endpoint was all-cause death at the 5-year follow-up. Hs-CRP and HbA1c data were collected on admission.

Results: The highest quartile of hs-CRP had a significantly increased the risk of all-cause death, with an adjusted HR of 1.747 (95 % CI 1.066-2.863), while, there was no difference in all-cause death among the groups of HbA1c after adjustment, with an adjusted HR of 1.383 (95 % CI 0.716-2.674). The highest quartiles for hs-CRP and HbA1c in the study population had a significantly increased risk of major adverse cardiac and cerebrovascular events (MACCE), with an adjusted hazard ratios (HR) of 1.263 (95 % confidence intervals [CI] 1.032-1.545) for hs-CRP and an adjusted HR of 1.417 (95 % CI 1.091-1.840) for HbA1c. Remarkably, the incidence of all-cause death and that of MACCE were significantly increased when both hs-CRP and HbA1c were elevated (HR 1.971, 95 % CI 1.079-3.601, P = 0.027 and HR 1.560, 95 % CI 1.191-2.042), P = 0.001, respectively). Addition of hs-CRP and HbA1c to conventional risk factors significantly improved prediction of the risk of all cause death (net reclassification index 0.492, P < 0.001; integrated discrimination improvement 0.007, P = 0.011) and MACCE (net reclassification index 0.160, P < 0.001; integrated discrimination improvement 0.006, P < 0.001).

Conclusions: Hs-CRP and HbA1c can serve as independent predictors of MACCE in patients with CCS undergoing PCI. Furthermore, a combination of hs-CRP and HbA1c could predict all cause death and MACCE better than each component individually.

Keywords: Chronic coronary syndromes; Glycosylated hemoglobinA1c; High-sensitivity C-Reactive protein; Percutaneous coronary intervention; Prognosis.