| Inflammation, statin therapy, and risk of stroke after an acute coronary syndrome in the MIRACL study. | |
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MedLine Citation:
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PMID: 17991875 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Patients with acute coronary syndromes have an increased risk of stroke. We measured markers of inflammation in the MIRACL study, a randomized trial of atorvastatin versus placebo in acute coronary syndromes, to assess the relationship of inflammation to stroke. METHODS AND RESULTS: Baseline C-reactive protein (CRP), serum amyloid A (SAA), and interleukin-6 (IL-6) were collected in 2926 (95%) subjects. Baseline markers were related to stroke risk over the 16 weeks of the study. Subjects who subsequently experienced a stroke had higher CRP (27.5 versus 10.2 mg/L, P=0.0032), SAA (30.5 versus 16.0 mg/L, P=0.031), IL-6 (11 231 versus 6841 pg/L, P=0.004), and troponin (6.03 versus 3.19 ng/mL P=0.0032). The risk of stroke was related to greater CRP, SAA, and IL-6 in the placebo group only. Similarly, there was a graded increase in risk of stroke across quartiles of inflammatory markers in the placebo patients only. CONCLUSIONS: In acute coronary syndromes, the early risk of stroke relates to both heightened inflammation and size of myocardial necrosis. Treatment with atorvastatin abrogated the risk associated with elevated markers of inflammation in this study, a finding that provides a novel rationale for the use of statins in acute coronary syndromes. |
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Authors:
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Scott Kinlay; Gregory G Schwartz; Anders G Olsson; Nader Rifai; Michael Szarek; David D Waters; Peter Libby; Peter Ganz; |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-11-08 |
Journal Detail:
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Title: Arteriosclerosis, thrombosis, and vascular biology Volume: 28 ISSN: 1524-4636 ISO Abbreviation: Arterioscler. Thromb. Vasc. Biol. Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-20 Completed Date: 2008-01-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9505803 Medline TA: Arterioscler Thromb Vasc Biol Country: United States |
Other Details:
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Languages: eng Pagination: 142-7 Citation Subset: IM |
Affiliation:
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Cardiovascular Division, Veterans Affairs Boston Healthcare System, West Roxbury, Mass, USA. skinlay@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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complications*,
drug therapy,
physiopathology Aged C-Reactive Protein / drug effects*, physiology Cholesterol, LDL / drug effects Female Heptanoic Acids / therapeutic use* Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use* Inflammation / drug therapy*, physiopathology Interleukin-6 / blood, metabolism Male Middle Aged Pyrroles / therapeutic use* ROC Curve Risk Factors Serum Amyloid A Protein / drug effects*, metabolism Stroke / epidemiology, immunology, prevention & control* |
| Chemical | |
Reg. No./Substance:
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0/Cholesterol, LDL; 0/Heptanoic Acids; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Interleukin-6; 0/Pyrroles; 0/Serum Amyloid A Protein; 110862-48-1/atorvastatin; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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