Changes Of High Sensitivity C-reactive Protein In Patients With Coronary Heart Disease Before And After Percutaneous Coronary Intervention And Their Connection With Prognosis

Objectives: To explore changes of high sensitivity C-reactive protein(Hs-CRP) in patients with coronary heart disease(CHD) before and after percutaneous coronary intervention(PCI) and their connection with prognosis.Methods: 100 patients with CHD [33 patients with stable angina pectoris (SAP);47 patients with unstable angina pectoris (UAP); 20 patients with acute myocardial infarction (AMI)]were treated with PCI. All samples were got 5 minutes before PCI and 48 hour after PCI. The serum levels of Hs-CRP 5 minutes before PCI and 48 hour after PCI were measured with Latex-enhanced immunoturbidimetry (LIT) in CHD group. 100 patients with CHD were divided into two groups according the serum levels of Hs-CRP 5 minutes before PCI and 48 hour after PCI, group A(Hs-CRP≥10mg/L) and group B(Hs-CRP<10mg/L).Cardiac events of two groups within 6 months after PCI were observed.Results:1. The levels of serum Hs-CRP in SAP group, UAP group and AMI group were (5.31±1.07)mg/L,(7.20±2.31)mg/L and (16.21±5.34)mg/L respectively. There is significant statistical difference among SAP, UAP and AMI groups(p<0.05). The serum levels of Hs-CRP 48 hours after PCI were significantly higher than those before PCI in SAP group[(8.47±1.37)mg/L], UAP group [(12.98±2.79)mg/L] and AMI group [(23.53±4.5)mg/L] respectively (P<0.05).2. There were 3 patients with cardiac death, 3 patients with nonfatal AMI, 5 patients with angina pectoris, 7 patients with cardiac insufficiency, 12 patients with arrhythmia and no patient with emergency CABG within 6 months after PCI in 100 patients with CHD. ①According to the level of serum Hs-CRP before PCI, group A(Hs-CRP≥10mg/L) has higher incidence rate of MACE and whole cardiac events than group B(Hs-CRP<10mg/L) within 6 months after PCI (P<0.05).②According to the level of serum Hs-CRP 48h after PCI, there was significant difference in the incidence rate of whole cardiac events within 6 months after PCI between group A and group B (P<0.05).Conclusions:1. The levels of serum Hs-CRP 5min before PCI in SAP group, UAP group and AMI group increased gradually. This means that inflammation has important effect in the occurrence and development of CHD. The higher the level of serum Hs-CRP ,the more inflammation, the more unstable plaque and the higher clinical risk. The level of serum Hs-CRP may reflect inflammatory state of atherosclerosis plaque and forecast occurrence of cardiac events.2. The serum level of Hs-CRP 48h after PCI elevated significantly compared with that 5min before PCI. This indicates PCI is likely to trigger and exacerbate coronary artery inflammation in a short time period.3. In patients with CHD, Hs-CRP≥10 mg/L, either 5 minutes before PCI or 48 hours after PCI, has certain prediction value for whole cardiac events within 6 months after PCI. Hs-CRP≥10mg/L 5min before PCI has even more prediction value of MACE. This indicates that aggressive drug therapy should be given for those CHD patients with higher level of serum Hs-CRP.