Comparison of effect of intensive lipid lowering with atorvastatin to less intensive lowering with lovastatin on C-reactive protein in patients with stable angina pectoris and inducible myocardial ischemia

Kinlay, Scott; Timms, Tracy; Clark, Maureen; Karam, Carolina; Bilodeau, Tim; Ridker, Paul M.; Rifai, Nader; Carlson, William D.; Lloyd‐Jones, Donald M.; Johnstone, Michael T.; Rubenstein, Joel J.; Alexander, Sidney; Orav, John; Stone, Peter H.

doi:10.1016/s0002-9149(02)02306-8

Cited by 70 publications

(29 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The endpoints of primary and secondary prevention studies have shown that, statin use significantly lowers hs-CRP levels in patients with CAD (24)(25)(26). In agreement with other investigations, we found that statin therapy is associated with development of collateral circulation (27,28 The development of coronary collaterals is mainly determined by the severity of coronary artery stenosis and the duration of myocardial ischemic symptoms (7,29).…”

Section: Discussionsupporting

confidence: 88%

Determinants of coronary collateral circulation in patients with coronary artery disease

Zorkun¹,

Akkaya²,

Zorlu³

et al. 2012

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective: This study aims to identify possible determinants of coronary collaterals in patients with severe coronary artery disease. Methods: The current study has a retrospective cohort design. Seventy four patients with ≥90% stenosis or total occlusion of the left anterior descending artery (LAD) were enrolled; coronary collateral grades, high-sensitive C-reactive protein (hs-CRP), fibrinogen, protein C and S, lipids, uric acid levels and medications applied before coronary angiography were noted and compared. Multiple logistic regression analysis was used for the multivariate analyses of independent variables associated with the development of adequate coronary collateral vessels. Results: The presence of coronary collaterals was significantly higher in males (p=0.018), with higher hs-CRP (p=0.023), prior statin use (p=0.022), and higher Gensini scores (p<0.001). In multiple logistic regression analysis, hs-CRP levels (OR=0.94, 95.0% CI=0.883-1.000, p=0.048), male gender (OR=4.73, 95.0% CI=1.441-15.539, p=0.010) and prior statin usage (OR=4.70, 95.0% CI=1.264-17.452, p=0.021) were identified as independent predictors of coronary collateral development. Conclusion: Male gender, prior statin usage, and higher hs-CRP levels are determinants of coronary collaterals in patients with coronary artery disease. (Anadolu Kardiyol Derg 2013; 13: 146-51) Key words: Coronary collateral circulation, coronary artery disease, high-sensitivity C-reactive protein, regression analysis Original Investigation Özgün Araşt›rma 146ÖZET Amaç: Bu çalışmada ciddi koroner arter hastalığı olanlarda koroner kollateral gelişimini sağlayan muhtemel nedenler araştırılmıştır. Yöntemler: Bu çalışma retrospektif kohort dizayna sahiptir. Sol ön inen arterde (SÖİA)-%90 ve daha fazla darlığı olan ya da (SÖİA) arteri tamamen tıkalı olan 74 hasta çalışmaya alınmıştır. Hastaların yüksek duyarlıklı C-reaktif protein (hs-CRP), fibrinojen, protein C ve S, lipid değerleri, ürik asit düzeyleri ile kullandığı ilaçlar tespit edilmiş ve koroner kollateral gelişimine göre karşılaştırılmıştır. Yeterli koroner kollateral gelişimi ile ilişkili bağımsız değişkenlerin belirlenmesinde çoklu lojistik regresyon analizi kullanılmıştır. Bulgular: Koroner kollateral gelişimi, erkek cinsiyette (p=0.018), önceden statin kullananlarda (p=0.022), yüksek hs-CRP düzeyi olanlarda (p=0.023) ve yüksek Gensini skoruna (p<0.001) sahip olan kişilerde daha fazla tespit edildi. Çoklu lojistik regresyon analizinde; hs-CRP düzeyleri (OR=0.94, %95.0 CI=0.883-1.000, p=0.048), erkek cinsiyet (OR=4.73, %95.0 CI=1.441-15.539, p=0.010) ve önceden statin kullanımı (OR=4.70, %95.0 CI=1.264-17.452, p=0.021) koroner kollateral gelişiminin bağımsız belirleyicileri olarak tespit edildi. Sonuç: Koroner arter hastalığı olanlarda erkek cinsiyet, statin kullanımı ve yüksek hs-CRP düzeyleri koroner kollateral gelişiminin belirleyicileridir.

show abstract

Section: Discussionsupporting

confidence: 88%

Determinants of coronary collateral circulation in patients with coronary artery disease

Zorkun¹,

Akkaya²,

Zorlu³

et al. 2012

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

show abstract

“…In this study, 12 weeks of atorvastatin 80 mg therapy was associated with 34% and 24% (SF and ST, respectively) reductions in hsCRP levels, which were greater than those observed i n studi es with other statins [15,19,21,22,[35][36][37][38][39]. Intensive dosing of atorvastatin helps to attenuate the inflammatory response present in high-risk patients [18,40].…”

Section: Discussionmentioning

confidence: 87%

“…In ACTFAST, high-dose atorvastatin (80 mg) was associated with greater reductions in serum hsCRP levels than lower doses. Other studies in patients with stable coronary disease, acute coronary syndromes, or diabetes have also reported greater reductions in hsCRP with higher compared to lower doses of statins [16,[38][39][40]. However, even the lowest dose, atorvastatin 10 mg was associated with significant reductions in hsCRP levels (SF group 18% (6 weeks) and 21% (12 weeks)).…”

Section: Discussionmentioning

confidence: 94%

Effect of atorvastatin on circulating hsCRP concentrations: A sub-study of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study

Gensini¹,

Gori²,

Dilaghi³

et al. 2010

International Journal of Cardiology

View full text Add to dashboard Cite

Background: Elevated C-reactive protein (CRP) concentration is a risk factor for cardiovascular events that may add prognostic information. Statin treatment is associated with significant reductions in CRP concentrations, which appear to be unrelated to the magnitude of LDL-cholesterol reduction. We investigated the effect of atorvastatin, across its dose range, on high sensitivity (hs)CRP in subjects at high cardiovascular risk. Methods: ACTFAST was a 12 week, prospective, multicenter, open-label trial in which high-risk subjects were assigned a starting dose of atorvastatin (10,20,40 Results: At baseline, ST subjects had significantly lower hsCRP levels than SF subjects (ST group 2.31, 95% CI 2.15, 2.48 mg/L vs. SF group 3.16, 95% CI 2.98, 3.34 mg/L, p b 0.05). In the SF group, atorvastatin 10 to 80 mg significantly (p b 0.01) reduced hsCRP levels in a dose dependent-manner. In ST group, additional hsCRP reductions were observed over the statin used at baseline, which were not dosedependent. Atorvastatin significantly decreased hsCRP concentrations in subjects with or without diabetes or the metabolic syndrome. Conclusions: Atorvastatin treatment at different doses, particularly 80 mg, significantly reduced hsCRP serum concentrations. This reduction was observed in both SF and ST groups and was independent of the presence of metabolic syndrome and/or diabetes. The beneficial effect of atorvastatin was evident at 6 weeks, supporting the practice of early introduction of higher doses of atorvastatin in high-risk patients.

show abstract

“…CRP levels decrease within 1 month with maximal fall after 12 months of statin treatment (43). Intracoronary infusion of the Rho-kinase inhibitor fasudil prevents acetylcholine-induced coronary artery constriction (44), and statins bind to integrins and interfere with the activation of Rho and other small protein triggers of inflammation.…”

Section: Studies In Manmentioning

confidence: 99%

Inflammation and Insulin Resistance

Bloomgarden¹

2003

Diabetes Care

View full text Add to dashboard Cite

Comparison of effect of intensive lipid lowering with atorvastatin to less intensive lowering with lovastatin on C-reactive protein in patients with stable angina pectoris and inducible myocardial ischemia

Cited by 70 publications

References 8 publications

Determinants of coronary collateral circulation in patients with coronary artery disease

Determinants of coronary collateral circulation in patients with coronary artery disease

Effect of atorvastatin on circulating hsCRP concentrations: A sub-study of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study

Inflammation and Insulin Resistance

Contact Info

Product

Resources

About