Low LDL levels but high hsCRP increase risk of adverse cardiac events post-PCI

Patients undergoing percutaneous coronary intervention (PCI), who had well-controlled LDL cholesterol (LDL-C) but persistently high levels of high-sensitivity C-reactive protein (hsCRP) were at a more than twofold greater risk for major adverse cardiac and cerebrovascular events, compared with those who had low LDL-C and low hsCRP levels.

Over a 1-year follow-up there was a stepwise increase in major adverse cardiovascular and cerebrovascular events.

Patients were categorized according to their serial hsCRP levels, with high hsCRP defined as at least 2 mg/L.

A stepwise increase in the primary end point of major adverse cardiac and cerebrovascular accident (MACCE), defined as death, myocardial infarction, or stroke, within 1 year of the second hsCRP measurement was noted.

The study, published in the May 21 issue of the Journal of the American College of Cardiology, was a retrospective analysis of a prospective PCI registry from Mount Sinai Hospital.

(Medscape excerpts)

Comments

·         High LDL levels with no underlying inflammation may have no consequence.

·         Normal LDL with high inflammation may be abnormal.

·         Always do lipid profile with hsCRP.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA