C-reactive protein levels and outcomes after statin therapy
C-reactive protein levels and outcomes after statin therapy
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DOI：
10.1056/nejmoa042378
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发表时间：
2005-01-06
影响因子：
158.5
通讯作者：
Braunwald, E
中科院分区：
文献类型：
--
作者：
Ridker, PM;Cannon, CP;Braunwald, E
背景：他汀类药物可降低低密度脂蛋白(LDL)、胆固醇和C反应蛋白(CRP)水平。方法：在3745例急性冠脉综合征患者中，我们评估了每天服用80 mg阿托伐他汀或40 mg普伐他汀后低密度脂蛋白胆固醇和C反应蛋白水平与再发心肌梗死或死于冠状动脉原因的风险之间的关系。结果：他汀类药物治疗导致低密度脂蛋白水平低于70毫克/分升(1.8mmoL/L)的患者的事件发生率低于高水平患者(2.7vs.4.0事件/百人年，P=0.008)。然而，在服用他汀类药物后C反应蛋白水平低于每升2毫克的患者和接受他汀类药物治疗后C反应蛋白水平较高的患者之间观察到的差异几乎是相同的(每百人年2.8vs.3.9次事件，P=0.006)，所有水平的低密度脂蛋白胆固醇都有这种效果。治疗后低密度脂蛋白>70 mg/分升者，复发事件发生率为4.6/100人年，C反应蛋白>2 mg/升者为3.2/100人年，低密度脂蛋白<70 mg/分升者分别为3.1和2.4次/100人年(P<0.05)。
BACKGROUND:Statins lower the levels of low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP). Whether this latter property affects clinical outcomes is unknown.METHODS:We evaluated relationships between the LDL cholesterol and CRP levels achieved after treatment with 80 mg of atorvastatin or 40 mg of pravastatin per day and the risk of recurrent myocardial infarction or death from coronary causes among 3745 patients with acute coronary syndromes.RESULTS:Patients in whom statin therapy resulted in LDL cholesterol levels of less than 70 mg per deciliter (1.8 mmol per liter) had lower event rates than those with higher levels (2.7 vs. 4.0 events per 100 person-years, P=0.008). However, a virtually identical difference was observed between those who had CRP levels of less than 2 mg per liter after statin therapy and those who had higher levels (2.8 vs. 3.9 events per 100 person-years, P=0.006), an effect present at all levels of LDL cholesterol achieved. For patients with post-treatment LDL cholesterol levels of more than 70 mg per deciliter, the rates of recurrent events were 4.6 per 100 person-years among those with CRP levels of more than 2 mg per liter and 3.2 events per 100 person-years among those with CRP levels of less than 2 mg per liter; the respective rates among those with LDL cholesterol levels of less than 70 mg per deciliter were 3.1 and 2.4 events per 100 person-years (P