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Scientific article
Open access
English

Residual inflammatory risk at 12 months after acute coronary syndromes is frequent and associated with combined adverse events

Published inAtherosclerosis, vol. 320, p. 31-37
Publication date2021-03
First online date2021-01-18
Abstract

Background and aims: Residual inflammatory risk (RIR) after acute coronary syndromes (ACS) may identify patients likely to benefit from anti-inflammatory therapies. Methods: Patients from the Special Program University Medicine ACS cohort were divided into four groups according to level of hsCRP at baseline and after 12 months: persistently high RIR, increased RIR (first low, then high hsCRP), attenuated RIR (first high, then low hsCRP), or persistently low RIR. High RIR was defined as hsCRP ≥ 2 mg/L. An independently adjudicated incident of combined adverse events was defined as the composite of myocardial infarction, clinically indicated coronary revascularization or cerebrovascular events. Results: Among 1209 patients with available hsCRP, clinical and demographic data, 295 (24.4%) patients had persistently high RIR (delta hsCRP median (IQR): 2.3 (-9.9; 0.3) (mg/L) and 72 (5.96%) patients had increased RIR (delta hsCRP median (IQR): +2.45 (1.2; 8.35) (mg/L). A total of 390 (32.26%) patients had attenuated RIR (delta hsCRP median (IQR): 3.55 (-10; -2) (mg/L) and 452 (37.38%) patients had persistently low RIR (delta hsCRP median (IQR): 0.2 (-0.6; 0.1) (mg/L). Of 90 combined adverse events, 31 (10.5%) occurred in the persistently high (multivariable adjusted OR: 1.71, (95% CI 1.08-2.7), p = 0.022) compared with the three other groups combined (increased RIR: 3 (4.2%), attenuated RIR 30 (7.7%), persistently low RIR 26 (5.8%). Conclusions: Persistently elevated hsCRP after ACS is found in a quarter of patients with the highest risk of combined adverse events. This underlines the need to perform anti-inflammatory intervention trials in RIR patients.

eng
Keywords
  • Biomarkers
  • CRP
  • Inflammation
  • Myocardial infarction
  • Risk factors
  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / epidemiology
  • Acute Coronary Syndrome / therapy
  • Anti-Inflammatory Agents / therapeutic use
  • Biomarkers
  • C-Reactive Protein / analysis
  • Humans
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / epidemiology
Funding
Citation (ISO format)
KLINGENBERG, Roland et al. Residual inflammatory risk at 12 months after acute coronary syndromes is frequent and associated with combined adverse events. In: Atherosclerosis, 2021, vol. 320, p. 31–37. doi: 10.1016/j.atherosclerosis.2021.01.012
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Article (Published version)
Identifiers
ISSN of the journal0021-9150
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Technical informations

Creation02/21/2022 3:32:00 PM
First validation02/21/2022 3:32:00 PM
Update time03/16/2023 6:36:23 AM
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