Statin therapy, inflammation and recurrent coronary events in patients following coronary stent implantation.
OBJECTIVE
We sought to investigate whether statin therapy affects the association between preprocedural C-reactive protein (CRP) levels and the risk for recurrent coronary events in patients undergoing coronary stent implantation.


BACKGROUND
Low-grade inflammation as detected by elevated CRP levels predicts the risk of recurrent coronary events. The effect of inflammation on coronary risk may be attenuated by statin therapy.


METHODS
We investigated a potential interrelation among statin therapy, serum evidence of inflammation, and the risk for recurrent coronary events in 388 consecutive patients undergoing coronary stent implantation. Patients were grouped according to the median CRP level (0.6 mg/dl) and to the presence of statin therapy.


RESULTS
A primary combined end point event occurred significantly more frequently in patients with elevated CRP levels without statin therapy (RR [relative risk] 2.37, 95% CI [confidence interval] [1.3 to 4.2]). Importantly, in the presence of statin therapy, the RR for recurrent events was significantly reduced in the patients with elevated CRP levels (RR 1.27 [0.7 to 2.1]) to about the same degree as in patients with CRP levels below 0.6 mg/dl and who did not receive statin therapy (RR 1.1 [0.8 to 1.3]).


CONCLUSIONS
Statin therapy significantly attenuates the increased risk for major adverse cardiac events in patients with elevated CRP levels undergoing coronary stent implantation, suggesting that statin therapy interferes with the detrimental effects of inflammation on accelerated atherosclerotic disease progression following coronary stenting.
Walter
D H
DH
Department of Internal Medicine IV, Division of Cardiology, University of Frankfurt, Frankfurt, Germany .
Fichtlscherer
S
S
Britten
M B
MB
Rosin
P
P
Auch-Schwelk
W
W
Schächinger
V
V
Zeiher
A M
AM
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000276:immunology; D023921:Coronary Stenosis / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D015607:Stents
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein