Prolonged CRP Increase After Percutaneous Coronary Intervention Is Associated with High Thrombin Concentrations and Low Platelet' Response to Clopidogrel in Patients with Stable Angina

Advances in Clinical and Experimental Medicine : Official Organ Wroclaw Medical University
Magdalena MostowikGrzegorz Gajos

Abstract

Inflammation is involved in all stages of development of atherosclerotic plaques. Currently, percutaneous coronary intervention (PCI) is a widely used method of treatment of coronary artery disease (CAD) when combined with optimal medical therapy (OMT). However, there is still controversy over invasive versus optimal pharmacological treatment in stable CAD (SCAD). Systemic inflammatory response triggered by PCI may limit its effectiveness in patients with SCAD. We aimed to evaluate plasma CRP and its relation to thrombin generation and platelet reactivity both early after the procedure and in a one-month observation following successful PCI with stent implantation, in patients with SCAD and OMT, including statins. We conducted a prospective study, in which CRP, platelet activation, thrombin generation and time course of prothrombin activation were determined at baseline, 3-5 days and 30 days after successful PCI with stent implantation, in 50 consecutive patients with SCAD, on chronic statin therapy. Early after PCI CRP increased by 176% as compared with baseline (p < 0.001) and one-month after angioplasty CRP was still 54% higher than before the procedure (p = 0.002). In multivariate model prolonged increase in CRP 1 month aft...Continue Reading

Citations

Aug 21, 2020·British Journal of Clinical Pharmacology·Catia MarzoliniDavid J Back
Sep 16, 2017·Clinical Pharmacology and Therapeutics·Christian SchoergenhoferBernd Jilma
Jan 19, 2020·Nature Reviews. Cardiology·Davide CapodannoDominick J Angiolillo

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