Document Detail


C-reactive protein level and the incidence of eligibility for statin therapy: the multi-ethnic study of atherosclerosis.
MedLine Citation:
PMID:  22886783     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Given the results of the Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial, statin initiation may be considered for individuals with elevated high-sensitivity C-reactive protein (hsCRP). However, if followed prospectively, many individuals with elevated CRP may become statin eligible, limiting the impact of elevated CRP as a treatment indication. This analysis estimates the proportion of people with elevated CRP that become statin eligible over time.
HYPOTHESIS: Most people with elevated CRP become statin eligible over a short period of time.
METHODS: We followed 2153 Multi-Ethnic Study of Atherosclerosis (MESA) participants free of cardiovascular disease and diabetes with low-density lipoprotein cholesterol <130 mg/dL at baseline to determine the proportion who become eligible for statins over 4.5 years. The proportion eligible for statin therapy, defined by the National Cholesterol Education Program (NCEP) 2004 updated guidelines, was calculated at baseline and during follow-up stratified by baseline CRP level (≥2 mg/L).
RESULTS: At baseline, 47% of the 2153 participants had elevated CRP. Among participants with elevated CRP, 29% met NCEP criteria for statins, compared with 28% without elevated CRP at baseline. By 1.5 years later, 26% and 22% (P = 0.09) of those with and without elevated CRP at baseline reached NCEP low-density lipoprotein cholesterol criteria and/or had started statins, respectively. These increased to 42% and 39% (P = 0.24) at 3 years and 59% and 52% (P = 0.01) at 4.5 years following baseline.
CONCLUSIONS: A substantial proportion of those with elevated CRP did not achieve NCEP-based statin eligibility over 4.5 years of follow-up. These findings suggest that many patients with elevated CRP may not receive the benefits of statins if CRP is not incorporated into the NCEP screening strategy.
Authors:
Devin M Mann; Daichi Shimbo; Mary Cushman; Susan Lakoski; Philip Greenland; Roger S Blumenthal; Erin D Michos; Donald M Lloyd-Jones; Paul Muntner
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2012-08-09
Journal Detail:
Title:  Clinical cardiology     Volume:  36     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-14     Completed Date:  2013-06-25     Revised Date:  2014-03-27    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  15-20     Citation Subset:  IM    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atherosclerosis / blood*,  ethnology*,  prevention & control
Biological Markers / blood
C-Reactive Protein / metabolism*
Dose-Response Relationship, Drug
Ethnic Groups*
Female
Fluorobenzenes / administration & dosage*,  therapeutic use
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*,  therapeutic use
Incidence
Male
Middle Aged
Prognosis
Pyrimidines / administration & dosage*,  therapeutic use
Retrospective Studies
Sulfonamides / administration & dosage*,  therapeutic use
Treatment Outcome
United States
Grant Support
ID/Acronym/Agency:
1K23DK081665/DK/NIDDK NIH HHS; K23 DK081665/DK/NIDDK NIH HHS; N01 HC095159/HC/NHLBI NIH HHS; N01 HC095165/HC/NHLBI NIH HHS; N01-HC-95159/HC/NHLBI NIH HHS; N01-HC-95165/HC/NHLBI NIH HHS; N01-HC-95169/HC/NHLBI NIH HHS; N01HC95159/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Fluorobenzenes; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Pyrimidines; 0/Sulfonamides; 287714-41-4/rosuvastatin; 9007-41-4/C-Reactive Protein
Comments/Corrections

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