Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

hsCRP Levels & Adverse CE Events After ACS

JAMA Cardiol; ePub 2019 Mar 6; Mani, et al

Increases in high-sensitivity C-reactive protein (hsCRP) levels during 16 weeks after an acute coronary syndrome (ACS) were associated with increased risk of a major adverse cardiac event (MACE), cardiovascular (CV) death, and all-cause death. This according to a secondary analysis of the Vascular Inflammation Suppression to Treat Acute Coronary Syndromes for 16 Weeks (VISTA-16) trial which include 5,145 patients assigned to receive varespladib or placebo on a background of atorvastatin treatment beginning within 96 hours of presentation with an ACS. Data from patients with available baseline and longitudinal hsCRP levels measured at weeks 1, 2, 4, 8, and 16 after randomization were evaluated. Outcomes were MACE, CV death, and all-cause death. Researchers found:

  • The median 16-week low-density lipoprotein cholesterol (LDL-C) level was 64.9 mg/dL and the median hsCRP level was 2.4 mg/L.
  • On multivariable analysis, higher baseline hsCRP level and higher longitudinal hsCRP level were independently associated with MACE.
  • Similar significant and independent associations were shown between baseline and longitudinal hsCRP levels and CV death and between baseline and longitudinal hsCRP levels and all-cause death.

Citation:

Mani P, Puri R, Schwartz GG, et al. Association of initial and serial C-reactive protein levels with adverse cardiovascular events and death after acute coronary syndrome: A secondary analysis of the VISTA-16 trial. [Published online ahead of print March 6, 2019]. JAMA Cardiol. doi:10.1001/jamacardio.2019.0179.