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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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01. History of Cardiology
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04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
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C-reactive protein level and risk of cardiovascular events in patients with coronary artery disease
Session:
SESSÃO DE COMUNICAÇÕES ORAIS 07 - PRÉMIO FERRER MELHOR COMUNICAÇÃO ORAL EM PREVENÇÃO SECUNDÁRIA
Speaker:
Gonçalo Bettencourt Abreu
Congress:
CPC 2025
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.3 Secondary Prevention
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Gonçalo Bettencourt Abreu; Isabel Mendonça; Débora Sá; Francisco Sousa; Matilde Ferreira; Eva Henriques; Sónia Freitas; Mariana Rodrigues; Sofia Borges; António Drummond; Ana Célia Sousa; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> The prognosis of cardiovascular disease can be predicted through various indicators, such as biochemical, imaging and genetic. C reactive protein (CRP) is a valuable inflammatory biomarker in different clinical conditions such as coronary artery disease (CAD). CRP biomarkers are easy to get, cheap, and sensitive for predicting deleterious events. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objective</strong>: To investigate the association between CRP levels and the risk of vascular and non-vascular outcomes in a Southern European population with CAD.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods</strong> We performed an extended prospective study with 1719 CAD patients with a follow-up of 7.3±6.5 years. All demographic, biochemical, and clinical data, as well as CRP levels, were collected. The outcome was CV events occurrence [myocardial infarction or unstable angina, ischemic stroke, new admission by heart failure, revascularization (angioplasty, CABG) or cardiovascular death]. CRP levels were stratified into quintiles (Q) below 10mg/L (1<sup>st</sup>Q CRP≤1.2mg/L; 2<sup>nd</sup>Q CRP 1.21-2.53mg/L; 3<sup>rd</sup>Q CRP 2.54-2.60mg/L; 4<sup>th</sup>Q CRP 2.61-3.69mg/L and 5<sup>th</sup>Q CRP 3.70-10mg/L and above 10mg/L (>10mg/L). Associations between baseline CRP concentrations and primary outcome were assessed using Cox proportional hazard models adjusted for all confounders (age, sex, smoking status, diabetes mellitus, body mass index, hypertension, diabetes, dyslipidemia, physical inactivity, alcohol and CAD family history). Kaplan-Meier estimated differences in the survival probability in each CRP quintile and in the subgroup >10mg/L.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results</strong>: After Cox regression analysis, physical inactivity (p=0.001), alcohol (p=0.049), and CRP (p<0.0001) remained in the equation as significantly associated with CV events. Specifically, the significances were: p=0.023 for 2<sup>nd</sup>Q; p=0.020 for 3<sup>rd</sup>Q; p=0.002 for 5<sup>th</sup>Q and p<0.0001 for CRP >10mg/L. CRP 4<sup>th</sup>Q did not reach statistical significance. The risk demonstrated by high CRP levels for the CV events occurrence is more significant than the previously established cardiovascular risk factors.</span></span></p> <p><strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Conclusion:</span></span></strong><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif"> Our findings demonstrated that higher CRP concentrations in coronary patients were independently associated with an increased risk of recurrent CVD events. As a biomarker, CRP highlights the importance of inflammation in cardiovascular disease. </span></span></p>
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