演題

Impact of High-sensitivity C-reactive Protein Level on Clinical Outcomes of Acute Coronary Syndrome Patients with Dyslipidemia Undergoing Contemporary Lipid-lowering Therapy

[演者] 渡辺 絵梨沙:1
[共同演者] 山口 淳一:1, 関口 治樹:1, 嵐 弘之:1, 小川 洋司:1, 萩原 誠久:1
1:東京女子医科大学 循環器内科

Background: Few reports elucidate the impact of high-sensitivity C-reactive protein (hs-CRP) level on clinical outcomes in acute coronary syndrome (ACS) patients with dyslipidemia undergoing contemporary lipid-lowering therapy. Methods: We examined the effect of hs-CRP in chronic phase of ACS on clinical outcomes retrospectively, using the study population of HIJ-PROPER, in which a total of 1,734 ACS patients with dyslipidemia were randomly assigned to receive statin-monotherapy or statin+ezetimibe. Participants were divided into subgroups according to quartiles of hs-CRP after 3 months of enrollment. Primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina and ischemia-driven coronary revascularizations.Results: During the study period (median 3.9 years), there were no significant differences in serial changes in LDL-C level among 4 groups. Kaplan-Meier analysis revealed that the incidence of primary endpoint (a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina and ischemia-driven coronary revascularizations) and all-cause death was significantly higher in the highest quartile of hs-CRP levels than those of other three groups (HR = 1.52, 95% CI: 1.16-2.00, p p<0.01 and HR = 5.30, 95% CI: 2.47-11.32, p p<0.01, respectively). Conclusion: Higher hs-CRP in a chronic phase after ACS was an independent predictor of worse clinical outcomes even in contemporary lipid-lowering therapy era, and the aggressive intervention for elevated inflammatory biomarkers might be an encouraging target.

[Keywords] clinical trial / inflammation
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