RACIAL DIFFERENCES IN LEVEL OF INFLAMMATION AND CLINICAL OUTCOMES BETWEEN EUROPEAN AND EAST ASIAN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION: THE COMPARE-CRP STUDY

초록

Background:Compared with Western, East Asian patients have shown a lower risk of ischemic event after PCI. Clinical evidences suggest East Asian vs. Western population has lower level of inflammation. We conducted a pooled analysis to evaluate relationship between inflammation and clinical outcomes across the races.Methods:The cohort consisted of PCI-treated East Asians (n=3,865) and Europeans (n=1,258) receiving DAPT. Level of inflammation was evaluated with hs-CRP on-admission and the criteria of high inflammation (HI) was defined as ‘hs-CRP≥2 mg/L’. MACE was defined as a composite of CV death, non-fatal MI, or ischemic stroke.Results:Europeans showed significantly higher level of hs-CRP than East Asians (3.3±8.0 vs. 2.0±5.4 mg/L, P<0.001), and HI was more frequently observed in Europeans vs. East Asian (32.3% vs. 19.4%, P<0.001). After adjustment, HI rate was significantly lower in East Asian vs. Europeans (OR 0.23; 95% CI 0.17-0.31; P<0.001). During 1-year follow-up, MACE occurred in 10.4% and 4.3% among Europeans and East Asians, respectively (HR 2.40; 95% CI 1.91-3.02; P<0.001) (Fig. A); this difference was more prominent in patients without HI (HR 3.31; 95% CI 2.47-4.43; P<0.001) (Fig. B and C). Conclusion:This analysis was the first to evaluate the influence of race on the level of inflammation and MACE in PCI-treated patients. Inflammation appeared important to explain