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Impact of C-reactive protein on in-stent restenosis: a meta-analysis.

Abstract
We sought to evaluate the impact of C-reactive protein (CRP) levels on in-stent restenosis after percutaneous coronary intervention.The plasma level of CRP is considered a risk predictor for cardiovascular diseases. However, the relationship between CRP and in-stent restenosis has been a matter of controversy. Meta-analysis reduces variability and better evaluates the correlation.We performed a systemic search for literature published in March 2008 and earlier, using MEDLINE(R), the Cochrane clinical trials database, and EMBASE(R). We also scanned relevant reference lists and hand-searched all review articles or abstracts from conference reports on this topic. Of the 245 studies that we initially searched, we chose 9 prospective observational studies (1,062 patients).Overall, CRP concentration was higher in patients who experienced in-stent restenosis. The weighted mean difference in CRP levels between the patients with in-stent restenosis and those without was 1.67, and the Z-score for overall effect was 2.12 (P=0.03). Our subgroup analysis that compared patients with stable and unstable angina showed a weighted mean difference in the CRP levels of 2.22 between the patients with and without in-stent restenosis, and the Z-score for overall effect was 2.23 (P=0.03) in 5 studies of unstable-angina patients. There was no significance in 4 studies of stable-angina patients.In spite of significant heterogeneity across the studies, our meta-analysis suggests that preprocedurally elevated levels of CRP are associated with greater in-stent restenosis after stenting and that this impact appears more prominent in unstable-angina patients.
AuthorsJian-Jun Li, Yi Ren, Ke-Ji Chen, Alan C Yeung, Bo Xu, Xin-Min Ruan, Yue-Jin Yang, Ji-Lin Chen, Run-Lin Gao
JournalTexas Heart Institute journal (Tex Heart Inst J) Vol. 37 Issue 1 Pg. 49-57 ( 2010) ISSN: 1526-6702 [Electronic] United States
PMID20200627 (Publication Type: Journal Article, Meta-Analysis, Review)
Chemical References
  • Biomarkers
  • C-Reactive Protein
Topics
  • Angioplasty, Balloon, Coronary (adverse effects, instrumentation)
  • Biomarkers (blood)
  • C-Reactive Protein (metabolism)
  • Coronary Artery Disease (blood, diagnosis, therapy)
  • Coronary Restenosis (blood, etiology)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Stents
  • Treatment Outcome
  • Up-Regulation

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