Application Of The Plasma Level Of High-sensitivity C-reactive Protein At1Year After Drug-eluting Stent Implantation

Background:In recent years, studies found that the main reason leading to acute cardiovascular events are coronary atherosclerotic plaque rupture and thrombosis,thrombosis also depends on the move atherosclerotic plaque instability. A large number of studies have shown that the inflammatory response are closely related to plaque vulnerability and plaque, Autopsy of patients with ACS, there are a lot of inflammatory cells in coronary atherosclerotic which is of the major cellular components, including macrophages and lymphocytes is invasive in the plaque fibrous cap macrophage the more the vulnerable plaques.Hs-CRP is a sensitive marker of systemic inflammation, is also found that the most important ACS inflammatory markers, hs-CRP with independent predictive ability of vulnerable plaqueTreatment of coronary heart disease, although made tremendous progress as a basis of drug treatment, but the PCI because of its intuitive, the exact effect is widely used in the clinical. From the PTCA to the bare metal stent (BMS), to the current drug-eluting stent (DES) implantation, significantly reduces stent restenosis rate and target vessel re-revascularization after PCI, coronary the risk of thrombosis is still a serious problem. DES not only inhibits vascular smooth muscle cells, also inhibit endothelial cell proliferation and migration, thereby blocking the re-endothelialization of vascular, thus extending the time of bare stents in endovascular, there is a theoretical risk of increased thrombosis. The current guidelines the provisions of the DES postoperative dual antiplatelet drugs (aspirin and clopidogrel) should be at least one year,but it was argued that the high-risk patients (with the formation of ultra-late thrombosis patients) need to be extended to2years.After PCI,intracoronary thrombus formation is associated with the inflammatory response, the more severe inflammatory response, the greater the risk of thrombosis, hs-CRP as inflammatory markers of vulnerable plaque with independent forecasts in theory also predict plaque rupture trigger thrombosis, can be used to guide the treatment of extended dual antiplatelet therapy after DES implantation of high-risk patients.Objective:Explore c-reactive protein (CRP) and in the drug-coated stents1years later after the application value.Methods:We prospectively included255patients treated with drug-eluting stents who had a high-sensitivity CRP measurement(hs-CRP) at1year after stent implantation. They are categorized into elevated hs-CRP group(n=106),nonelevated hs-CRP group(n=149).The baseline characteristics and major cardiovascular events(MACE)between two groups were compared. Results:After1year DES impantation,elevated CRP was observed in41.56%of the study population. There were significant differences between the rates of hypertension history, the rates of multivessel lesion,the rates of diffuse lesions,and left ventricular ejection fraction,LDL-cholesterol,Lipoprotein(a),HbA1C of the two groups(P<0.05).16.0%of patients in the elevated CRP group had angina as compared with7.4%of those in the nonelevated hs-CRP level group(P <0.05).8.5%of patients in the elevated hs-CRP level group and2.0%of those in the nonelevated hs-CRP level group had nonfatal myocardial infarction(P<0.05).4.7%of patients in the elevated hs-CRP level group and1.3%of those in the nonelevated hs-CRP level group had nonfatal stroke(P>0.05).For revascularization,the rate was17.0%in the elevated hs-CRP level group and10.7%in the nonelevated hs-CRP group(P>0.05).Conclusion:Elevated CRP levels at1year after drug-eluting stent implantation were significantly associated with the patient’s condition such as hypertension history, coronary multivessel lesion and diffuse lesion, poor left ventricular ejection fraction, elevated LDL-cholesterol and Lipoprotein(a), elevated HbA1C, and elevated CRP may increased the risks of major cardiovascular events.