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The impact of plasma levels of C-reactive protein, lipoprotein (a) and homocysteine on the long-term prognosis after successful coronary stenting

The global evaluation of new events and restenosis after stent implantation study

Michael N. Zairis, MD^*,*, John A. Ambrose, MD, FACC, Stavros J. Manousakis, MD^*, Alexander S. Stefanidis, MD^*, Olga A. Papadaki, MD^*, Helen I. Bilianou, MD^*, Mary C. DeVoe, RN, Constantine N. Fakiolas, MD^*, Evangelos G. Pissimissis, MD^*, Christopher D. Olympios, MD^*, Stefanos G. Foussas, MD, FESC, FACC^* GENERATION Study Group

^* Department of Cardiology, Tzanio Hospital, Piraeus, Greece
Department of Medicine, The Comprehensive Cardiovascular Center, Saint Vincent Catholic Medical Centers, New York, New York, USA

View larger version (24K): [in a new window]   Figure 1 ROC curves of biochemical markers for the primary end point (A) and cutoff points for CRP (B) or Lp(a) (C). ROC area was 0.77; 95% CI 0.70 to 0.83; p < 0.001, ROC area 0.67; 95% CI 0.60 to 0.72; p < 0.001, ROC area 0.51; 95% CI 0.44 to 0.59; p = 0.71 for CRP, Lp(a) and tHCY, respectively. CRP = C-reactive protein; Lp(a) = lipoprotein(a); Se = sensitivity; Sp = specificity; tHCY = total homocysteine.

View larger version (19K): [in a new window]   Figure 2 Distribution of the three-year composite primary end point or its components between the subgroups of the studied biochemical markers. CD = cardiac death; CPE = composite primary end point; CRP = C-reactive protein; Lp(a) = lipoprotein(a); MI = nonfatal myocardial infarction; tHCY = total homocysteine; UA = rehospitalization for rest unstable angina. *p = after adjustment for the other univariate predictors of the event.

View larger version (22K): [in a new window]   Figure 3 Kaplan-Meier curves of the composite primary end point between the groups of CRP (A), Lp(a) (B), and tHCY (C) defined by the cutoff points of these biochemical markers. CRP = C-reactive protein; Lp(a) = lipoprotein(a); tHCY = total homocysteine.

View larger version (19K): [in a new window]   Figure 4 Distribution of the one-year incidence of CLR, ISR or PTSL between the subgroups of the studied biochemical markers. CLR = clinical recurrence of symptoms; CRP = C-reactive protein; ISR = in-stent restenosis; Lp(a) = lipoprotein(a); PTSL = progression to significant lesion; tHCY = total homocysteine. *p = after adjustment for the other univariate predictors of the event.