Elevated hsCRP Tied to Poor Outcomes After ACS
A secondary analysis of results from the VISTA-16 trial suggests that serial hsCRP measurements may improve post-ACS risk stratification and help decrease subsequent CV events.
Elevated high-sensitivity C-reactive protein (hsCRP) at the time of acute coronary syndrome (ACS) and during follow-up may portend poor CV outcomes and death, according to a new study published in
“Monitoring high-sensitivity C-reactive protein levels in patients after acute coronary syndrome may help better identify [those] at greater risk for recurrent cardiovascular events or death,” wrote first author Preethi Mani, MD, of the Cleveland Clinic, and colleagues.
CRP is an inflammatory biomarker that usually increases shortly after the start of pain during ACS, and declines gradually over the following week. Medical therapy, including statins, can accelerate this decrease. Studies suggest that CRP levels may predict adverse CV events, and that hsCRP may better predict such outcomes.
The current study was a secondary analysis of data from the
Analyses adjusted for baseline clinical, treatment, and laboratory factors showed that high baseline hsCRP and high hsCRP over time were independently linked to increased risk for major adverse cardiovascular events (MACE).
The risk for MACE was increased by 36% with high baseline hsCRP, and by 15% when hsCRP remained elevated over 16 weeks of follow-up.
Likewise, risk for CV death was significantly increased with high baseline hsCRP and hsCRP during follow-up (61% increased risk; 26% increased risk, respectively), as well as all-cause death (58% increased risk; 25% increased risk, respectively).
VISTA-16 was ended early when it became clear that varespladib did not improve CV outcomes, and may cause harm. Thus, results showing a link between varespladib and adverse outcomes may be biased. Outcomes beyond 16 weeks cannot be determined.
Source: Mani P, Puri R, Schwartz GG, et al.
