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Long-term predictive value of high sensitivity c-reactive protein for cancer mortality in patients undergoing percutaneous coronary intervention

Session Cardiovascular events in malignancies: from prediction to prevention

Speaker Hirohisa Endo

Congress : ESC Congress 2018

  • Topic : cardiovascular disease in special populations
  • Sub-topic : Cardio-Oncology
  • Session type : Rapid Fire Abstracts
  • FP Number : 6134

Authors : H Endo (Tokyo,JP), T Dohi (Tokyo,JP), K Miyauchi (Tokyo,JP), T Funamizu (Tokyo,JP), J Shitara (Tokyo,JP), H Wada (Tokyo,JP), S Doi (Tokyo,JP), H Iwata (Tokyo,JP), T Kasai (Tokyo,JP), S Okazaki (Tokyo,JP), K Isoda (Tokyo,JP), H Daida (Tokyo,JP)

H. Endo1 , T. Dohi1 , K. Miyauchi1 , T. Funamizu1 , J. Shitara1 , H. Wada1 , S. Doi1 , H. Iwata1 , T. Kasai1 , S. Okazaki1 , K. Isoda1 , H. Daida1 , 1Juntendo University, Department of Cardiovasculer Medicine - Tokyo - Japan ,

European Heart Journal ( 2018 ) 39 ( Supplement ), 1271

Background: Recent evidence suggests that anti-inflammatory therapy might reduce not only cardiovascular event but also occurrence of lung cancer. The relevance between the mortality due to cancer and high sensitivity C-reactive protein (hs-CRP) level remains unclear.

Purpose: We aimed to investigate the impact of hs-CRP level on long-term cancer mortality in patient with coronary artery disease.

Methods: This is a part of retrospective analysis of a single-center prospective percutaneous coronary intervention (PCI) registry (n=4589, enrolled from January 2000 to December 2016). In the present study, patients with the available data of baseline hs-CRP were analyzed (84.2%, n=3863). Patients were divided into two groups according to the median value of hs-CRP. We then evaluated the association between baseline hs-CRP level and both all-cause death and cancer death after PCI procedure.

Result: Of the entire cohort, mean age was 66.3±10.5 years and male gender was 82.5%. The median value of hs-CRP was 0.12 mg/dL (interquartile range (IQR): 0.05 to 0.37 mg/dL). The median follow-up period was 6.3 years (IQR: 2.6 to 6.3 years). There were 663 deaths (17.1%) including 228 (5.9%) cardiovascular deaths and 208 (5.3%) cancer deaths. In 208 cancer deaths, the proportion of gastrointestinal cancer was 43.9% (n=100) and lung cancer was 18.9% (n=43). Kaplan-Meier analysis revealed that higher hs-CRP group had a significantly higher incidence of both all-cause and cancer death (log-rank p<0.0001) (Figure 1). A multivariate Cox hazard model adjusted by clinical significant covariates showed higher hs-CRP level was significantly associated with higher risk of cancer death (hazard ratio: 2.13, 95% CI: 1.59–2.89, p<0.0001).

Conclusion: Elevated levels of baseline hs-CRP are associated with increased risk of cancer death in patients undergoing PCI. Hs-CRP measurement may be useful for identification of high-risk subgroups for anti-inflammatory interventions.

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