Document Detail


Inflammation, statin therapy, and risk of stroke after an acute coronary syndrome in the MIRACL study.
MedLine Citation:
PMID:  17991875     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-11-08
Journal Detail:
Title:  Arteriosclerosis, thrombosis, and vascular biology     Volume:  28     ISSN:  1524-4636     ISO Abbreviation:  Arterioscler. Thromb. Vasc. Biol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-20     Completed Date:  2008-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505803     Medline TA:  Arterioscler Thromb Vasc Biol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  142-7     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Veterans Affairs Boston Healthcare System, West Roxbury, Mass, USA. skinlay@partners.org
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / 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:
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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