Relationships of hsCRP to High-Risk Vulnerable Plaque After NSTEMI

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions Pub Date : 2025-05-26 DOI:10.1016/j.jcin.2025.01.440

Ole Fröbert MD , Gregg W. Stone MD , Alf Inge Larsen MD , Zhipeng Zhou MA , Lak N. Kotinkaduwa PhD , Thomas Engstrøm MD , Lars Kjøller-Hansen DMSc , Michael Maeng MD, PhD , Mitsuaki Matsumura BS , Ori Ben-Yehuda MD , Hans Erik Bøtker MD, PhD, DMSc , Jonas Persson MD, PhD , Rune Wiseth MD, PhD , Lisette O. Jensen MD, PhD , Jan E. Nordrehaug MD , Thor Trovik MD, PhD , Ulf Jensen MD, PhD , Øyvind Bleie MD, PhD , Stefan K. James MD , Ziad A. Ali MD, DPhil , Akiko Maehara MD

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引用次数: 0

Abstract

Background

Inflammation is a driver of atherosclerosis and susceptibility to cardiovascular events.

Objectives

The authors sought to evaluate whether high-sensitivity C-reactive protein (hsCRP) levels are associated with the prevalence of high-risk coronary plaques in patients with non–ST-segment elevation myocardial infarction (NSTEMI).

Methods

PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) II was a multicenter, prospective study enrolling patients with recent myocardial infarction. Following treatment of all flow-limiting lesions, 3-vessel imaging with near-infrared spectroscopy and intravascular ultrasound was used to characterize untreated nonculprit lesions. We investigated the association between baseline hsCRP and plaque morphology (lipid content, plaque burden, lumen area) in 501 NSTEMI patients. hsCRP levels were categorized as low (<1 mg/L), intermediate (1-3 mg/L), or high (>3 mg/L).

Results

The percentages of patients with at least 1 highly lipidic plaque (maximum lipid core burden index for any 4-mm pullback length ≥324.7) increased from 39.4% to 57.2% to 59.3% in the low, intermediate, and high hsCRP groups, respectively (P = 0.01). The proportion of patients with at least 1 highly lipidic plaque with ≥70% burden increased with hsCRP levels from 22.7% to 27.2% to 36.7%, respectively (P = 0.01). Multivariable analyses showed that increasing hsCRP was associated with higher total coronary artery lipid core burden index and plaque volume. Higher hsCRP increased the odds of having any highly lipidic plaque and those with ≥70% plaque burden.

Conclusions

Among patients with recent NSTEMI, a high baseline hsCRP level was associated with the presence of pan-coronary atherosclerosis and focal high-risk plaques. (PROSPECT II & PROSPECT ABSORB - an Integrated Natural History Study and Randomized Trial; NCT02171065)

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hsCRP与NSTEMI后高危易损斑块的关系：来自PROSPECT II试验的见解

背景：炎症是动脉粥样硬化和心血管事件易感性的驱动因素。目的：作者试图评估高敏c反应蛋白（hsCRP）水平是否与非st段抬高型心肌梗死（NSTEMI）患者高危冠状动脉斑块的患病率相关。方法：PROSPECT（为研究冠状动脉树事件的预测因素提供区域观察）II是一项多中心、前瞻性研究，纳入了近期心肌梗死患者。在所有血流受限病变治疗后，使用近红外光谱和血管内超声对未治疗的非罪魁祸首病变进行三血管成像。我们研究了501例NSTEMI患者的基线hsCRP与斑块形态（脂质含量、斑块负荷、管腔面积）之间的关系。hsCRP水平较低（3 mg/L）。结果：在低、中、高hsCRP组中，至少有1个高脂斑块（任何4 mm回拉长度≥324.7时最大脂质核心负担指数）的患者比例分别从39.4%增加到57.2%和59.3% （P = 0.01）。随着hsCRP水平的升高，至少有1个高脂斑块且负担≥70%的患者比例分别从22.7%增加到27.2%和36.7% （P = 0.01）。多变量分析显示，hsCRP升高与冠状动脉总脂质核心负荷指数和斑块体积升高有关。较高的hsCRP增加了任何高脂斑块和斑块负担≥70%的患者的几率。结论：在近期NSTEMI患者中，高基线hsCRP水平与泛冠状动脉粥样硬化和局灶性高危斑块的存在相关。PROSPECT II & PROSPECT absorption——一项综合自然历史研究和随机试验；NCT02171065)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Cardiovascular interventions CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

11.60

自引率

8.80%

发文量

756

审稿时长

4-8 weeks

期刊介绍： JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.