Coronary disease & ACSCohort study
Local vs systemic inflammation and outcomes after percutaneous coronary intervention
- Prospective cohort study
Authors' conclusion
Local coronary inflammation shows a stronger association with adverse outcomes after PCI than systemic inflammation. Integrating both markers improves risk stratification and may support inflammation-guided management in patients with CAD.
Study context
- Population
- Patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI)
- Participants
- 1,987 patients · 2,436 vessels
- Exposure
- Local coronary inflammation vs systemic inflammation
- Outcome
- MACE:
- All-cause mortality
- Non-fatal MI
- Unplanned repeat revascularization
- Follow-up
- median 3-year follow-up
Main finding
As reported in the abstract
MACE
Each group vs low FAI-MAXHazard ratio (95% CI)
High FAI-MAX
3.25(2.29–4.61)
High FAI-MAX + elevated hs-CRPhighest risk
4.00(2.47–6.32)
High local + low systemic inflammation
2.88(1.85–4.49)
Low local + high systemic inflammation
1.09(0.55–1.85)
- Patients with major adverse cardiovascular events (MACE)
- 164 (8.3%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| VOCE (vessel level) · median 3-year follow-up — High FAI-MAX vs Low FAI-MAX | 3.15 (2.06–4.82) | |
| VOCE (vessel level) · median 3-year follow-up — High FAI-MAX + elevated hs-CRP vs Low FAI-MAX | 4.15 (2.37–7.25) | |
| VOCE (vessel level) · median 3-year follow-up — High local + low systemic inflammation vs Low FAI-MAX | 2.64 (1.55–4.50) | |
| VOCE (vessel level) · median 3-year follow-up — Low local + high systemic inflammation vs Low FAI-MAX | 1.08 (0.55–2.13) | |
| 0.10.31310Hazard ratio (log scale) |
- Vessel-oriented composite endpoint (VOCE) (vessel level) — Vessels with VOCE
- 118 of 2,436 (4.8%)
Model discrimination
- Both markers improved discrimination vs either alone
- DeLong P < 0.05
Sensitivity analysis excluding revascularization
- Advantage of isolated high FAI-MAX attenuated; dual-high phenotype remained significant
Original publication
Local vs systemic inflammation and outcomes after percutaneous coronary intervention. Eur Heart J. Published 29 August 2026. doi:10.1093/eurheartj/ehag731
Summarised from the published abstract; every number is checked against it