Document Detail

HMG-CoA reductase inhibitors for lowering elevated levels of C-reactive protein.
MedLine Citation:
PMID:  15540478     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Clinical trials evaluating the effectiveness of therapy with hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors for reducing elevated C-reactive protein (CRP) levels and associated coronary events are reviewed. SUMMARY: Atherosclerotic plaque growth may be attenuated with therapy aimed at minimizing inflammation. Because increased levels of CRP have been associated with arterial-wall inflammation, statins can prevent ischemia by both inhibiting deposition of lipids and decreasing inflammation. Evaluation of recent clinical trials, including WOSCOPS, PRINCE, AFCAPS/ TexCAPS, MIRACL, CURVES, REVERSAL, and JUPITER, demonstrated the correlation of statin therapy with decreased levels of CRP. WOSCOPS found that patients with CRP values of > 4.59 mg/L at baseline were at the highest risk of coronary events. The PRINCE trial evaluated the antiinflammatory effects of pravastatin and found a mean 16.9% reduction in CRP levels after 24 weeks of therapy. AFCAPS/TexCAPS researchers found that lovastatin provded a 14.8% reduction in the median levels of CRP (p < 0.001). The MIRACL study showed that atorvastatin reduced CRP levels by 83% (p < 0.001). Researchers in the CURVES study found a significant reduction in CRP levels with pravastatin, simvastatin, and atorvastatin compared with baseline (p < 0.025). Results of the REVERSAL study linked atorvastatin with a 36.4% decrease in CRP levels, while pravastatin was associated with a 5.2% decrease (p < 0.0001). JUPITER is ongoing and will determine whether long-term use of rosuvastatin can reduce the rate of coronary events. CONCLUSION: The lowering of elevated CRP levels by statins may reduce the risk of coronary events independently of the effect of statins on lipid levels.
Kristine Y Chan; Elizabeth S Boucher; Pritesh J Gandhi; Matthew A Silva
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists     Volume:  61     ISSN:  1079-2082     ISO Abbreviation:  Am J Health Syst Pharm     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-11-15     Completed Date:  2004-12-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9503023     Medline TA:  Am J Health Syst Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1676-81     Citation Subset:  IM    
St. Luke's Medical Center, Milwaukee, WI, USA.
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MeSH Terms
C-Reactive Protein / antagonists & inhibitors*,  metabolism
Clinical Trials as Topic
Coronary Artery Disease / drug therapy,  metabolism,  prevention & control
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 9007-41-4/C-Reactive Protein

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