C‑reactive protein as a prognostic factor for coronary artery bypass graft failure and unfavourable myocardial revascularization outcomes

Aim . To analyze the effect of elevated high-sensitivity C-reactive protein (hs-CRP) on the clinical course and complexity of coronary artery disease (CAD), and the risk of coronary artery bypass graft (CABG) failure. Material and methods . The study included 84 patients with stable CAD who underwent examination and isolated CABG. Evaluation of hs-CRP levels was performed before surgery, 24 hours and 7 days after CABG. Control coronary bypass angiography was performed intraoperatively and 1 year after CABG. Results . We found that chronic increase in hs-CRP levels affects the complexity of CAD (Syntax Score) and the development of critical unfavorable prognostic coronary lesions. The risk of hemodynamically significant stenosis of the left coronary artery trunk increases 6-fold (odds ratio 5,9; 95% confidence interval (CI): 1,89-18,5). Dysfunction of coronary conduits was determined in 12% of patients 1 year after CABG, which was caused by thrombotic vein graft occlusion in 70% and hemodynamically significant graft stenosis in 30% of cases. These patients had significantly higher hs-CRP levels at all testing time points (before surgery, 24 hours and 7 days after CABG), indicating a more pronounced activation of inflammatory mechanisms. Predictive analysis established a significant role of hs-CRP levels before surgery (relative risk (RR) 1,43; 95% CI: 1,23-1,67, p