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C-Reactive Protein Level Does Not Modify Statin Benefit

Even with low baseline CRP concentrations, statin therapy reduces vascular disease risk

FRIDAY, Jan. 28 (HealthDay News) -- Baseline C-reactive protein (CRP) concentration does not alter the benefit of statin therapy for high-risk patients, according to a study published online Jan. 28 in The Lancet.

Jonathan Emberson, Ph.D., from Oxford University in the United Kingdom, and colleagues from the Heart Protection Study (HPS) Collaborative Group analyzed 20,536 men and women aged 40 to 80 at high risk of vascular events. Participants were randomly assigned to 40 mg simvastatin daily or placebo for an average of five years. Patients were categorized according to their baseline CRP concentration. Analysis by intention to treat measured major vascular events defined as coronary death, myocardial infarction, stroke, or revascularization.

The investigators found that treatment with simvastatin resulted in a 24 percent proportional reduction in the incidence of a first major cardiovascular event. This reduction was not found to vary with baseline CRP concentration (P trend = 0.41). In participants with the lowest baseline CRP concentration, major vascular event incidence was reduced by 29 percent. No significant difference in the relative risk was seen in the various combinations of high or low baseline concentrations of CRP and low-density lipoprotein (LDL) cholesterol. A clear benefit was noted for patients with low CRP and low LDL cholesterol.

"The findings in HPS, that reducing LDL cholesterol with simvastatin reduces the risk of major vascular events to a similar extent irrespective of presenting CRP concentrations (including among individuals with low concentrations of both CRP and LDL cholesterol), are probably broadly generalizable to other statins," the authors write.

Funding for the study was provided by Merck, Roche Vitamins, and GlaxoSmithKline. One of the study authors disclosed financial relationships with pharmaceutical companies, including Merck and GlaxoSmithKline.

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