{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:05:56Z","timestamp":1792789556344,"version":"4.5.0"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,26]],"date-time":"2025-01-26T00:00:00Z","timestamp":1737849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Italian Ministry of Health","award":["RC1302CA23"],"award-info":[{"award-number":["RC1302CA23"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Elevated high-sensitivity C-reactive protein (hsCRP) levels are associated with poor cardiovascular outcomes, particularly in patients with advanced peripheral arterial disease (PAD). This study aimed to assess the impact of hsCRP on clinical characteristics and long-term outcomes in a cohort of PAD patients. Methods: A total of 346 patients with advanced PAD were enrolled and stratified into two groups based on their median hsCRP level (Group 1: &lt;0.32 mg\/dL, Group 2: &gt;0.32 mg\/dL). The patients were followed for a mean of 102.70 \u00b1 44.13 months. Their clinical characteristics, comorbidities, and long-term cardiovascular events, including myocardial and\/or peripheral revascularization, ischemia, and death, were analyzed. This study evaluated two composite endpoints: major adverse cardiovascular events (MACEs) and major adverse peripheral events (MAPEs). MACEs comprised fatal cardiovascular events, cerebral ischemia, cardiac infarction, myocardial revascularization, acute peripheral arterial occlusion, and peripheral reperfusion. MAPEs included carotid reperfusion, acute peripheral arterial occlusion, and lower limb revascularization. Results: The patients in Group 2 had a higher body mass index, waist circumference, and waist\u2013hip ratio compared to those in Group 1 (all p &lt; 0.05). Inflammatory markers, including fibrinogen and the erythrocyte sedimentation rate, were significantly elevated in Group 2 (both p &lt; 0.01). While the overall incidence of peripheral revascularization was similar between groups, these interventions occurred significantly earlier in Group 2 (28.24 \u00b1 38.87 months vs. 67.04 \u00b1 49.97 months, p = 0.004; HR: 2.015, 95% CI: 1.134\u20133.580, p = 0.017). The MAPEs were comparable in number, but occurred earlier in Group 2 (36.60 \u00b1 37.35 months vs. 66.19 \u00b1 48.18 months, p &lt; 0.01; HR: 1.99, 95% CI: 1.238\u20133.181, p = 0.004). Similarly, the MACEs had an earlier onset in Group 2 (40.31 \u00b1 38.95 months vs. 55.89 \u00b1 46.33 months, p = 0.04; HR: 1.62, 95% CI: 0.983\u20131.987, p = 0.062). A total of 169 deaths were recorded during the follow-up. Group 2 exhibited a significantly higher mortality rate (56% vs. 42%, p &lt; 0.01) and an earlier trend in mortality (76.58 \u00b1 43.53 months vs. 84.86 \u00b1 5.18 months), although this difference did not reach statistical significance (p = 0.22). Conclusions: Elevated hsCRP levels (&gt;0.32 mg\/dL) are associated with a worse clinical profile and earlier adverse events in patients with advanced PAD. Group 2 experienced significantly earlier peripheral revascularization, MACEs, and MAPEs. The mortality rates were also significantly higher, highlighting the prognostic value of hsCRP in this population.<\/jats:p>","DOI":"10.3390\/jcm14030815","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T07:54:08Z","timestamp":1738050848000},"page":"815","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Role of C-Reactive Protein as a Predictor of Early Revascularization and Mortality in Advanced Peripheral Arterial Disease"],"prefix":"10.3390","volume":"14","author":[{"given":"Giuseppe","family":"Di Stolfo","sequence":"first","affiliation":[{"name":"Cardiovascular Department, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3218-1646","authenticated-orcid":false,"given":"Mario","family":"Mastroianno","sequence":"additional","affiliation":[{"name":"Scientific Direction, Fondazione IRCCS Casa Sollievodella Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele Antonio","family":"Pacilli","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"De Luca","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Rosario","family":"Coli","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester Maria Lucia","family":"Bevere","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Pacilli","sequence":"additional","affiliation":[{"name":"Emergency Department, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico Rosario","family":"Potenza","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Mastroianno","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1782","DOI":"10.1093\/eurheartj\/ehu203","article-title":"Anti-inflammatory therapies for cardiovascular disease","volume":"35","author":"Ridker","year":"2014","journal-title":"Eur. 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