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PubMed2004

Importance of complex additional stenosis after primary angioplasty for acute myocardial infarction in medium-term prognosis.

BACKGROUND: There is some controversy about the ideal type of revascularization in the context of primary angioplasty (percutaneous coronary intervention--PCI) for acute myocardial infarction (AMI). The presence of additional stenosis, especially if complex, can have an impact on prognosis. OBJECTIVES: To evaluate medium-term (1-year) prognosis according to the presence of complex additional stenosis after primary PCI. POPULATION AND METHODS: A retrospective study of 138 consecutive patients admitted to our unit for ST-segment elevation AMI who underwent primary PCI. Patients were followed up for 1 year and divided in 2 groups: without complex additional stenosis (n = 69, 61 +/- 14 years, 62% males) and with complex additional stenosis (n = 69, 65 +/- 13 years, 73% males, p = NS). We evaluated demographic characteristics, risk factors for coronary artery disease, previous cardiac history and signs of heart failure on admission. Angiographic characteristics, medication and PCI outcome were also evaluated. The impact of these variables on the combined end-point of death, reinfarction, and myocardial revascularization at 1 year was assessed. RESULTS: The angiographic success rate was 96.4%. Twenty-four percent of patients were aged 75 years or over and 4.3% of the total population were in Killip class IV on admission. Anterior AMI was slightly more common in the non-complex additional stenosis group (60% vs. 44%, p = 0.06), and inferior AMI in the complex additional stenosis group (26% vs. 42%, p = 0.07). One-vessel disease was more prevalent in the group without complex additional stenosis, as expected (86% vs. 11%, p < 0.001) and stent implantation was also more frequent in this group (96% vs. 86%, p = 0.08). There were no differences in other variables. Death/reinfarction/revascularization was more frequent in the group with complex additional stenosis (13% vs. 32%, p = 0.014). Sixty-seven per cent of the events occurred in the first 30 days of follow-up. At 1 year, univariate predictors of outcome were Killip class > or = 2, TIMI flow < 3 in the infarct-related vessel after PCI, non-use of glycoprotein IIb/IIIa receptor antagonists, beta-blockers or statins, multivessel disease, and the presence of complex additional stenosis (log rank, p = 0.003). Using multivariate regression analysis, the independent predictors of outcome at 1 year were Killip class > or = 2 (OR 0.28; 95% CI 0.08-0.93, p = 0.037) and the presence of complex additional stenosis (OR 0.32; 95% CI 0.12-0.84, p = 0.020). CONCLUSIONS: The presence of complex additional stenosis after primary PCI had a worse prognosis at 1 year, suggesting the need for further interventions to stabilize the plaque, particularly in the first 30 days after AMI.

Adult↗
PubMed2004

[Pathological evaluation of soft tissue sarcoma for diagnosis, prognosis and treatment].

Soft tissue sarcomas (STS) are rare and heterogeneous group of tumors which differ widely in their clinicopathological features, and have a wide spectrum of clinical course, ranging from indolent tumors with a good prognosis to highly aggressive tumors with a poor prognosis. The diagnostic process of STS is complex and may necessitate an array of ancillary studies, including immunohistochemistry, electron microscopy and molecular genetic methods. Although an ongoing and improved histopathological definition of individual tumor types has been established, there still remains a subset of mesenchymal tumors which are currently not readily classifiable. This review summarizes our experience and that of others in the approach to the pathological evaluation of STS, and especially emphasizes the need to use emerging molecular techniques that can provide important clues for diagnosis, prognosis, and treatment of STS.

Humans↗
PubMed2004

[Effect of cyclooxygenase-2,and matrix metalloproteinase-2 expression on prognosis of lung cancer].

BACKGROUND & OBJECTIVE: Expression of cyclooxygenase-2 (COX-2)and matrix metalloproteinase-2 (MMP-2)increased in most tumor tissues. Inhibitors of both COX-2 and MMP-2 have been experimentally and clinically proved effective against the development of tumor. Our study was designed to investigate the expression of COX-2 and MMP-2, and the effect of those proteins on lymphoid metastasis and prognosis of lung cancer. METHODS: SP immunohistochemistry was used to determine the expression of COX-2 and MMP-2 in 42 patients with lung cancer. Kaplan-Meier and log-rank test were used to compare the survival time of positive staining group and negative staining group. RESULTS: The positive rate of COX-2 was 31%, and that of MMP-2 was 62%. The survival time in positive COX-2 group was significantly shorter than that in negative COX-2 group (P=0.019). The lymphoid metastasis rate of positive MMP-2 group was significantly higher than that of negative MMP-2 group (P=0.009). The survival time in positive MMP-2 group was significantly shorter than that in negative MMP-2 group (P=0.001). No relationship was found between the expression of COX-2 and MMP-2 (P=0.257). CONCLUSION: The expression of COX-2 and MMP-2 are closely correlate with the prognosis of lung cancer, and the over-expression of those proteins suggest poor prognosis in patients with lung cancer.

Adenocarcinoma↗
PubMed2004

[Constructing a Cox proportional hazard regression model of prognosis factors of acute myocardial infarction by retrospective cohort study].

OBJECTIVE: To study the effects of the potential factors, including Chinese herbal decoction, on the long-term prognosis of acute myocardial infarction (AMI). METHODS: Previous clinical data of 162 patients with AMI were collected, who were followed-up to observe the important events for prognosis, as death and cardio-cerebral episode, and the Cox proportional hazards regression model was used to assess the relative factors. RESULTS: The degree of cardiac function (by New York grading) increased 1 grade when age increased for 10 years, and the relative hazardous degree (RHD) raised to 1.983 and 3.169. After treatment with Chinese herbal decoction and angiotensin converting enzyme inhibitor (ACEI), the RHD could be reduced to 0.177 and 0.161 respectively. Taking the important cardio-cerebral events, including death, as the endpoint, when age increased for 10 years, the cardiac function would increase for 1 grade and RHD of endpoint events increased to 2.021 and 1.863, if patients had history of anterior infarction, arrhythmia and diabetes mellitus, it increased to 2.903, 2.588 and 4.039 respectively. Chinese decoction and ACEI treatment could reduce it to 0.093 and 0.141 respectively. CONCLUSION: Age, heart failure, anterior infarction, arrhythmia and diabetes mellitus are the hazardous factors of the long-term prognosis of AMI, Chinese herbal decoction and ACEI are the protective factors.

Adult↗
PubMed2002

[Correlation of the expression of MDR genes and MDR genes-coded product with prognosis in laryngopharyngeal malignant melanoma].

OBJECTIVE: To study the correlation of expression implication of MDR genes (GST-pi and Topo II) and MDR gene-coded product (Pgp) with prognosis in laryngopharyngeal malignant melanoma. METHOD: Using immunohistochemical S-P method,expression of GST-pi, Topo II and Pgp was detected in 28 cases of laryngopharyngeal malignant melanoma. The relationship between GST-pi, Topo II, Pgp and clinicopathological features, prognosis of the tumors were also analyzed. RESULT: The positive rates of Pgp, GST-pi and Topo II were 35.7%, 57.1% and 46.4% respectively in 28 cases of laryngopharyngeal malignant melanoma, without significant difference (P > 0.05). The positive rates of Pgp, GST-pi and Topo II were not correlated with sex,age, size of tumor and Clark's grade, Breslow's grade (P > 0.05), but AJC grade and prognosis (P < 0.05). CONCLUSION: Expression of Pgp,GST-pi and Topo II may be the chief mechanism of multi-drug resistance. Detection of multi-drug resistance genes is of necessity and feasibility when predicting the effect of chemotherapy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2004

[Correlation of expression of heparanase to angiogenesis and prognosis of breast cancer].

BACKGROUND & OBJECTIVE: Heparanase is a heparan sulfate proteoglycan cleaving enzyme. It helps to degrade extracellular matrix and basement membrane, promote angiogenesis, and accelerate tumor metastasis. This study was to investigate correlation of heparanase expression to angiogenesis and prognosis of breast cancer. METHODS: Immunohistochemistry was used to detect heparanase and microvessel density (MVD) in 120 specimens of infiltrative ductal breast cancer, and 10 specimens of normal breast tissue. Correlation of heparanase expression to clinicopathologic factors and prognosis of breast cancer were analyzed using Chi-square test, t test, Kaplan-Meier method, and log-rank test. RESULTS: Positive rate of heparanase in breast cancer was 65% (78/120), significantly higher than that in normal breast tissue (0, 0/10) (P< 0.05). MVD in breast cancer was 53.84+/-13.45, significantly higher than that in control group (33.32+/-8.55) (P< 0.01). Expression of heparanase positively correlated with tumor size, histological grade, lymph node metastasis, and clinical stage (P< 0.05) of breast cancer, and negatively correlated with 5-year survival rate (P< 0.05). MVD in heparanase positive group was much higher than that in heparanase negative group (P< 0.05), MVD positively correlated with heparanase expression (r=0.358,P< 0.01). CONCLUSION: Heparanase may promote angiogenesis, and may closely correlate with prognosis of breast cancer.

Adult↗
PubMed2004

[Analysis of prognosis assessment with acute physiology and chronic health evaluation III, multiple organ dysfunction score and sequential organ failure assessment for the postoperative patients in cardiovascular surgery].

OBJECTIVE: To analyze the clinical significance of the prognosis assessment with acute physiology and chronic health evaluation III (APACHEIII), multiple organ dysfunction score (MODS) and sequential organ failure assessment (SOFA) for postoperative patients in cardiovascular surgery. METHODS: Prognosis of 68 patients undergoing cardiovascular operation from February 2004 to June 2004 in our ward was assessed by APACHE III, MODS and SOFA. Then the scores were calculated and compared everyday while they stayed in Cardiac Surgery Intensive Care Unit (CSICU). RESULTS: The scores of three methods showed no significant difference from one another in the first three postoperative days, but were significantly higher than all the scores calculated just after the entrance to the CSICU (A0, M0, S0; all P<0.01). There were no differences in the changes of APACHE III, MODS and SOFA(DeltaA, DeltaM and DeltaS) in the first three postoperative days respectively, although they all showed a decreasing tendency. APACHE III scores were positively correlated with MODS although the correlation were diminishing (P<0.01 at first day but P<0.05 at third day), while they were positively correlated with SOFA only in the first two days (both P<0.01). The MODS was positively correlated with SOFA at various time points (P<0.001). The length of stay in CSICU was positive correlated with A0 and maximum of APACHEIII (Amax, P<0.05), and M0, maximum of MODS (Mmax) as well as S0, maximum of SOFA (Smax, P<0.001), respectively. CONCLUSION: For the patients who have undergone cardiovascular operation, A0 could assess the prognosis fairly precisely, but MODS and SOFA assessment seem to be better than APACHE III. Individual Smax and kinetic DeltaS might be the most suitable indexes for cardiovascular surgery.

APACHE↗
PubMed1992

[Intraspinal epidural hematomas. Treatment and prognosis].

The results of treatment in 26 patients with spinal epidural haematoma are analysed in respect of pre-operative factors related to prognosis. The material consists of the two patients treated at Haukeland Hospital since 1980 and 24 patients described in the literature over the same period. This condition affects people of all ages. It should be suspected in cases of sudden excruciating spinal pain and progressive paraparesis. Factors with a poor prognosis were a haematoma covering many spinal levels and having a thoracic localization. To a lesser extent, a greater degree of preoperative neurological deficit and a longer duration from symptom debut to operation had a negative effect on prognosis. These patients require speedy diagnosis before total paralysis is established. They should be operated as soon as possible.

Adolescent↗
PubMed2004

[Evaluation of prognosis and recurrence of hepatocellular carcinoma treated from 1988 to 2002 at Department of Medicine III, Kyushu University Hospital].

From a series of 452 consecutive patients with hepatocellular carcinoma (HCC) admitted to the department of Medicine III, Kyushu University Hospital between January 1988 and December 2002, patients were evaluated, who met the following criteria: (a) the patients had not been diagnosed with HCC previously, (b) they had a solitary HCC less than 4 cm in diameter, or had fewer than three tumors with diameters less than 3 cm, and (c) patients with extrahepatic metastasis or vessel invasion were excluded. Five-year survival was more than 60%, and there were no significant differences in survival among the periods of 1988 - 1989, 1990 - 1994, and 1995 - 2002. There were significant differences in survival among patients with tumors of diameters < 2 cm (80%), 2 - 3 cm (60%), 3 < (40%) cm, and among those with tumor numbers of 1 (70%), 2 (50 %), 3 - 4 tumors (30%). The study also analyzed variables that could influence prognosis or recurrence of HCC, including tumor size and number, parameters of hepatic function, combined therapy with transcatheter arterial chemoembolization and local recurrence. Multivariate regression analysis showed that indocyanine green retention at 15 min serum albumin level, and local recurrence were significant independent predictors of survival, and that serum albumin and alanine aminotransferase levels were significant independent predictors of recurrence. In conclusion, achieving complete necrosis of HCC at first treatment to prevent local recurrence is important for improving the prognosis of patients with HCC. In addition, ameliorating hepatitis, by antiviral treatment for example, to maintain hepatic function is also important for improving both the prognosis and the prevention of the recurrence.

Adult↗
PubMed2004

[Comparison between tow methods of acute physiology and chronic health evaluation III and acute lung injury scale to evaluate the severity and prognosis of severe acute respiratory syndrome].

OBJECTIVE: To evaluate the acute physiology and chronic health evaluation III (APACHE III) and acute lung injury (ALI) scale in the severity and prognosis of severe acute respiratory syndrome (SARS). METHODS: The clinical data of 38 SARS patients, including survivors (24 cases) and no survivors (14 cases) were collected and evaluated with APACHE III and ALI scoring systems. The correlation of scores and prognosis was evaluated. RESULTS: The scores of APACHE III in the non survivors were higher remarkably than those in the survivor group (P < 0.001). The scores of APACHE III had positive correlation with the overall fatality rate. When the scores of APACHE III was higher than 60, the mortality increased obviously (chi(2) = 3.886, P < 0.05). Elderly patients with SARS who were over 60 years old had a high mortality (chi(2) = 8.660, P < 0.05). The scores of ALI in the non survivors had not statistical significance than those in the survivor group (P = 0.127). CONCLUSIONS: The score of APACHE III in the SARS are correlated with the patient's condition and prognosis. Elderly patients with SARS have a high mortality.

APACHE↗
PubMed2005

The high expression of Fractalkine results in a better prognosis for colorectal cancer patients.

Local and systemic immune responses are impaired in patients with colorectal cancer (CRC) and it is known that the number of tumor infiltrating lymphocytes (TILs) is considerably few. On the other hand, some CRC cases in which many TIL were observed, survived longer than those cases with a small number of TIL. Considerable attention has been recently paid to the relationship between chemokines and tumor cells. Some chemokines recruit lymphocytes for tumor lesions. We made a hypothesis that Fractalkine, a CX3C chemokine, would recruit lymphocytes in the CRC and play an important role in anti-tumor immunity. We analyzed the expression level of Fractalkine in CRC cell lines as well as in clinical samples (n=80). The expression level of Fractalkine was thus found to correlate with the density of TIL (p<0.05). The CRC cases with a strong Fractalkine expression (n=50) showed a significantly better prognosis than those with a weak expression (n=30) (p<0.05). In addition, the Fractalkine expression was found to be an independent prognostic factor (p<0.05). We furthermore clarified that some of the tumor-infiltrating cells were natural killer cells and cytotoxic T cells expressed Fractalkine receptor. These data suggest that Fractalkine expressed in the tumor appears to recruit cytotoxic T cells and NK cells to the tumor site and these cytotoxic cells result in a better prognosis mediated by tumor cell cytotoxicity using a perforin and granzyme B mechanism. The expression level of Fractalkine was an essential biomarker for predicting the prognosis of patients with CRC. Fractalkine is considered to be one of the biomarkers for detecting patients with a high risk for recurrence, and who might therefore benefit from additional therapeutic strategies such as adjuvant therapy.

Biomarkers, Tumor↗
PubMed2004

Cyclin E, p27 and mutant p53 do not predict the prognosis in AJCC stage II colorectal carcinomas.

BACKGROUND/AIMS: Carcinogenesis is characterized by the abnormal regulation of cell cycle. The abnormal expression of the regulators of cell cycle may be related to the prognosis. Since the clinical significance of the expression of the three proteins in colorectal carcinomas is still controversial, we evaluated the prognostic value of the expression of cyclin E, p27 and mutant p53 in stage II colorectal cancer. METHODS: The expression levels of cyclin E, p27 and mutant p53 proteins in 41 patients with stage II colorectal carcinomas were analyzed by immunohistochemistry. RESULTS: In the univariate analysis, the level of CEA at diagnosis was associated with disease relapse. In the multivariate analysis, the clinicopathological variables such as age, gender, site of primary tumor, tumor size, state of tumor differentiation and preoperative plasma CEA level were not associated with disease relapse. When Kaplan-Meier survival curves were constructed to determine the prognosis, cyclin E, p27 and mutant p53 expressions did not predict poor prognosis. CONCLUSIONS: Our results suggested that the expression of cyclin E, p27 and mutant p53 proteins did not predict the clinical outcome in the stage II colorectal carcinomas.

Adenocarcinoma↗
PubMed2005

Prognosis of non-small cell lung cancer patients by detecting circulating cancer cells in the peripheral blood with multiple marker genes.

PURPOSE: Current lung cancer staging and prognosis methods are based on imaging methods, which may not be sensitive enough for early and accurate detection of metastasis. This study aims to validate the use of a panel of markers for circulating cancer cell detection to improve the accuracy of cancer staging, prognosis, and as a rapid assessment of therapeutic response. EXPERIMENTAL DESIGN: We analyzed the National Cancer Institute-Cancer Genome Anatomy Project database to identify potential marker genes for the detection of circulating cancer cells in peripheral blood. Nested real-time quantitative PCR and a scoring method using cancer cell load Lc were employed to correlate the amount of circulating cancer cells with clinical outcomes in 54 non-small cell lung cancer (NSCLC) patients. The Kaplan-Meier method was employed for analysis of prognostic variables. RESULTS: A panel of four marker genes was identified and experimentally validated. With these marker genes, we achieved an overall positive detection rate of 72% for circulating cancer cells in the peripheral blood of NSCLC patients. Patients who had higher Lc values had worse outcomes and shorter survival times. Patients with poor therapeutic response were revealed by positive detection of circulating cancer cells after therapy. The results correlated well with the patients' survival time. CONCLUSION: Circulating cancer cell detection by a panel of markers and the Lc scoring method can supplement the current tumor, node, metastasis staging method for improved prognosis and for rapid assessment of therapeutic response. Together, they may facilitate the design of better therapeutic strategies for the treatment of NSCLC patients.

Aged↗
PubMed2005

Protein expression profiling identifies subclasses of breast cancer and predicts prognosis.

Breast cancer is a heterogeneous disease whose evolution is difficult to predict by using classic histoclinical prognostic factors. Prognostic classification can benefit from molecular analyses such as large-scale expression profiling. Using immunohistochemistry on tissue microarrays, we have monitored the expression of 26 selected proteins in more than 1,600 cancer samples from 552 consecutive patients with early breast cancer. Both an unsupervised approach and a new supervised method were used to analyze these profiles. Hierarchical clustering identified relevant clusters of coexpressed proteins and clusters of tumors. We delineated protein clusters associated with the estrogen receptor and with proliferation. Tumor clusters correlated with several histoclinical features of samples, including 5-year metastasis-free survival (MFS), and with the recently proposed pathophysiologic taxonomy of disease. The supervised method identified a set of 21 proteins whose combined expression significantly correlated to MFS in a learning set of 368 patients (P < 0.0001) and in a validation set of 184 patients (P < 0.0001). Among the 552 patients, the 5-year MFS was 90% for patients classified in the "good-prognosis class" and 61% for those classified in the "poor-prognosis class" (P < 0.0001). This difference remained significant when the molecular grouping was applied according to lymph node or estrogen receptor status, as well as the type of adjuvant systemic therapy. In multivariate analysis, the 21-protein set was the strongest independent predictor of clinical outcome. These results show that protein expression profiling may be a clinically useful approach to assess breast cancer heterogeneity and prognosis in stage I, II, or III disease.

Adult↗
PubMed2004

[Prospective study on prognosis of infants with neonatal subependymal cysts].

OBJECTIVES: It is confirmed that most neonatal subependymal cysts (SEC) are closely correlated with intrauterine infection and the short-term prognosis of SEC is not very good. Little information about the long-term prognosis of SEC is available. The purpose of the present study was to explore the short-term and long-term prognosis of neonatal SEC cases via a 6-year follow up. METHODS: Seventy SEC neonates detected by cranial ultrasound between October 1993 and October 1994 were enrolled into SEC group and 70 healthy neonates into control group. Serum antibodies (IgG and IgM) to cytomegalovirus (CMV), toxoplasma and rubella virus and PCR for these pathogens (except for rubella virus) were measured in the two groups. CMV-PCR was also performed for urine specimens. Cranial sonography assessment, physical growth evaluation, Bayley developmental scale or Wyeth developmental scale, brain-stem auditory evoked potential (BAEP) and vision examination were undertaken at 3, 6, 12 months and 6 years in the two groups. RESULTS: The positive rate of CMV-IgM and blood CMV-PCR in SEC group was significantly higher than those of control group (19.1% vs. 5.7%, 12.9% vs. 2.9%). The positive rate of urine CMV-PCR in SEC group was also significantly higher (40% vs 17.1%). No significant difference could be found in the positive rate of PCR for toxoplasma and rubella-IgM between the two groups. The weight and height of infants with SEC were obviously lower than those in control group during the first year after birth. The parameters of the physical development in SEC infants reached the similar level as controls till 6 years old. However, the index of mental development below 80 was more often seen in infants with SEC comparing to that in control group during the whole six years. There were no abnormal findings either in BAEP or vision examination in the two groups. CONCLUSION: Infants with SEC may show a transient retardation of physical growth after birth, while their mental developmental retardation might last for longer time. It is suggested that cranial ultrasound examination should be performed in all neonates for the detection of SEC, and a longer follow-up should be done for infants with SEC.

Antibodies↗
PubMed2004

[Association of polymorphisms in testosterone 5-alpha-reductase II genotype and prognosis factors of prostate cancer].

OBJECTIVE: The correlation were studied between testosterone 5-alpha-reductase II (SRD5A2) gene polymorphisms and prognosis factors. METHODS: V89L and A49T variants was identified with Mwo1 and Rsa1. The differences of V89L and A49T between cancer of prostate (CaP) and benign prostatic hyperplasia (BPH) were studied. In addition, we also researched the association of polymorphisms with age of onset, free prostate specific antigen (FPSA), total PSA (TPSA), FPSA/TPSA (F/T), Gleason score, and T stage in cancer group. RESULTS: We found no differences of V89L and A49T polymorphisms between CaP and BPH. In CaP group the A49T variant was associated with lower age of onset (P = 0.03) and higher Gleason score (P = 0.015). There were no differences between VV and VL+LL polymorphisms with any of the characteristics studied. When the characteristics above were regarded as two-level discrete variable, there were no differences by A49T and V89Lvariants. CONCLUSION: In CaP group, the AT+TT genotype was perhaps associated with poor prognosis. VL+LL genotype has no relation with prognosis.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed2005

[Radiotherapeutic effect and prognosis of bulky exophytic cervical cancer].

OBJECTIVE: To retrospectively analyze the factors affecting the radiotherapeutic effects and prognosis of patients with bulky exophytic cervical cancer. METHODS: Sixty-four patients with bulky exophytic cervical cancer with a maximal diameter measuring 5 to 8 cm (mean 6.5 cm) were treated with a combined radiotherapy with external beam, interstitial, intracavitary irradiations. According to the FIGO staging system, 9 patients were classified as stage IIA, 19 as IIB, 5 as IIIA, and 31 as IIIB. The patients were restaged according to the same system based on the history records at the fourth week in the radiotherapy course. The cumulative survivals were analyzed with Kaplan-Meier method, and the factors influencing the prognosis including age, histology, maximal tumor diameter, stage before treatment and restage in radiotherapy were analyzed with Cox regression model. RESULTS: Restaging during radiotherapy classified 9 patients as stage I, 28 as IIA, 13 as IIB, 5 as IIIA, and 9 as IIIB. The 5-year overall survival rate was 81% and the 5-year relapse-free survival rate 75.8%. Multivariate Cox regression analyses identified the restage in radiotherapy as the only significant, independent prognostic factor for overall survival (P<0.01). CONCLUSIONS: Radiotherapy can achieve satisfactory results for patients with bulky exophytic cervical cancer. The stage before treatment is inaccurate and not indicative of the prognosis, but the restage in radiotherapy can serve as a significant and independent prognostic factor.

Adult↗
PubMed2005

[Value of systematic biological markers of inflammation for the prognosis at 12 months of patients undergoing programmed coronary angioplasty].

Value of systematic dosage of biological markers of inflammation for the prognosis at 12 months of patients undergoing programmed coronary angioplasty Systematic dosage of proteins of inflammation has been suggested for assessing the prognosis of athero-thrombotic diseases. The authors undertook a study of plasma C-reactive protein (CRP) and interleukin 6 (IL-6) for evaluating the prognosis of patients undergoing programmed coronary angioplasty. A prospective monocentric study of 117 patients (65 +/- 8 years) was divided into a control group of 28 patients undergoing coronary angiography (Group 1) and 89 patients undergoing programmed coronary angioplasty (Group 2). Serum IL-6 and CRP levels were measured before arterial puncture and at H12 and H24 after coronary catheterisation. The follow-up period was 12 months. The angioplasty did not significantly increase CRP and IL-6 concentrations compared with coronary angiography. Twenty patients (Group 2) (22%) suffered a cardiovascular event in the 12 months' follow-up. These patients had significantly higher CRP levels at H0, H12 and H24 after coronary angioplasty than those who had uncomplicated outcomes. This was not observed for IL-6 concentrations because of the wide dispersion of the results obtained. Increased CRP concentrations between H0 and H24 was also a good predictive factor independently of high basal CRP levels potentially due to other causes than atheroma. Coronary angioplasty is associated with increased CRP at H0, H12 and H24. These values are correlated with the risk of future events at 6 and 12 months. This information is easily obtained and should help management of these patients.

Aged↗