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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Peikert, A; Kaier, K; Merz, J; Manhart, L; Schäfer, I; Hilgendorf, I; Hehn, P; Wolf, D; Willecke, F; Sheng, X; Clemens, A; Zehender, M; von, Zur, Mühlen, C; Bode, C; Zirlik, A; Stachon, P.
Residual inflammatory risk in coronary heart disease: incidence of elevated high-sensitive CRP in a real-world cohort.
Clin Res Cardiol. 2020; 109(3):315-323
Doi: 10.1007/s00392-019-01511-0
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- Leading authors Med Uni Graz
- Peikert Alexander
- Zirlik Andreas
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- Abstract:
- BACKGROUND: Inflammation drives atherosclerosis and its complications. Anti-inflammatory therapy with interleukin 1 beta (IL-1β) antibody reduces cardiovascular events in patients with elevated high-sensitive C-reactive protein (hsCRP). This study aims to identify the share of patients with coronary heart disease (CHD) and residual inflammation who may benefit from anti-inflammatory therapy. METHODS: hsCRP and low-density lipoprotein (LDL) levels were determined in 2741 all-comers admitted to the cardiological ward of our tertiary referral hospital between June 2016 and June 2018. Patients without CHD, with acute coronary syndrome, chronic or recurrent systemic infection, use of immunosuppressant or anti-inflammatory agents, chronic inflammatory diseases, chemotherapy, terminal organ failure, traumatic injury and pregnancy were excluded. RESULTS: 856 patients with stable CHD were included. 42.7% of those had elevated hsCRP ≥ 2 mg/l. Within the group of patients with LDL-cholesterol < 70 mg/dl, 30.9% shared increased hsCRP indicating residual inflammation. After multivariate adjusted backward selection elevated Lipoprotein (a) (OR 1.61, p = 0.048), elevated proBNP (OR 2.57, p < 0.0001), smoking (OR 1.70, p = 0.022), and obesity (OR 2.28, p = 0.007) were associated with elevated hsCRP. In contrast, the use of ezetimibe was associated with normal hsCRP (OR 0.51, p = 0.014). In the subgroup of patients with on-target LDL-cholesterol < 70 mg/dl, backward selection identified elevated proBNP (OR 3.49, p = 0.007) as independent predictor of elevated hsCRP in patients with LDL-cholesterol < 70 mg/dl. CONCLUSION: One-third of all-comers patients with CHD showed increased levels of hsCRP despite a LDL-cholesterol < 70 mg/dl potentially qualifying for an anti-inflammatory therapy. Elevated proBNP is an independent risk factor for hsCRP elevation.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged - administration & dosage
- Anti-Inflammatory Agents - therapeutic use
- Anticholesteremic Agents - administration & dosage
- Atherosclerosis - prevention & control
- C-Reactive Protein - metabolism
- Cholesterol, LDL - blood
- Cohort Studies - administration & dosage
- Coronary Disease - drug therapy, physiopathology
- Cross-Sectional Studies - administration & dosage
- Ezetimibe - administration & dosage
- Female - administration & dosage
- Humans - administration & dosage
- Incidence - administration & dosage
- Inflammation - drug therapy, physiopathology
- Male - administration & dosage
- Natriuretic Peptide, Brain - metabolism
- Peptide Fragments - metabolism
- Retrospective Studies - administration & dosage
- Find related publications in this database (Keywords)
- hsCRP
- Cardiovascular disease
- Inflammation
- Real-world cohort
- Coronary heart disease
- LDL-cholesterol