Inflammation during acute coronary syndromes - Risk of cardiovascular events and bleeding.

Nanchen, David; Klingenberg, Roland; Gencer, Baris; Räber, Lorenz; Carballo, David; von Eckardstein, Arnold; Windecker, Stephan; Rodondi, Nicolas; Lüscher, Thomas F; Mach, François; Muller, Olivier; Matter, Christian M (2019). Inflammation during acute coronary syndromes - Risk of cardiovascular events and bleeding. International journal of cardiology, 287, pp. 13-18. Elsevier 10.1016/j.ijcard.2019.03.049

[img] Text
Nanchen IntJCardiol 2019_epub.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (475kB) | Request a copy

BACKGROUND Many parameters can affect the level of inflammation during acute coronary syndromes (ACS). We aimed to assess the one-year risk of major adverse cardiovascular events (MACE) and bleeding associated with elevated hsCRP levels during ACS, taking into account the severity of myocardial infarction, the timing of blood sampling and established long-term prognostic factors. METHODS We studied 1864 consecutive patients with ACS enrolled in a contemporary multicenter prospective cohort study in Switzerland. HsCRP levels were determined at hospital admission. One year after discharge MACE and bleeding events were assessed. Multivariable adjusted Cox proportional hazards were computed with age, sex, time from symptom onset to blood draw, body mass index, current smoking, hypertension, diabetes mellitus, pre-existing cardiovascular disease, history of inflammatory disease, LDL-cholesterol levels, type of ACS, left ventricular ejection fraction and GRACE 1.0 risk score. RESULTS At one-year follow-up, 151 (8.1%) patients suffered MACE. Compared to patients with hsCRP below 2 mg/l, the risk of MACE was higher in patients with hsCRP levels between 2 and 5 mg/l, with a multivariate adjusted hazard ratio (HR) of 1.63 (95% confidence interval (CI) 0.93-2.84), in those with levels between 5 and 10 mg/l, with a HR of 2.80 (95% CI 1.58-4.96), and in those with levels above 10 mg/l, with a HR of 2.23 (95% CI 1.28-3.88). There was no difference in bleeding risk between the four groups. CONCLUSIONS Systemic inflammation in the acute phase of myocardial infarction is an independent predictor for cardiovascular events, but not for bleeding.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Räber, Lorenz; Windecker, Stephan and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0167-5273

Publisher:

Elsevier

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

23 Apr 2019 09:22

Last Modified:

25 Oct 2019 17:59

Publisher DOI:

10.1016/j.ijcard.2019.03.049

PubMed ID:

31003794

Uncontrolled Keywords:

Acute coronary syndromes HsCRP Inflammation Prevention Prognosis

BORIS DOI:

10.7892/boris.130259

URI:

https://boris.unibe.ch/id/eprint/130259

Actions (login required)

Edit item Edit item
Provide Feedback