C-reactive protein, statins, and the primary prevention of atherosclerotic cardiovascular disease.
Emerging data implicate inflammation as integral to atherosclerosis and its complications. From a clinical perspective, the inflammatory biomarker C-reactive protein has demonstrated consistent predictive value in the detection of individuals at high risk for cardiovascular disease. Therapy with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) reduces C-reactive protein as well as low-density lipoprotein cholesterol, thus providing a potential additional mechanism for the reduction in cardiovascular events associated with the use of these agents. Evidence from the Air Force/Texas Coronary Atherosclerosis Prevention Study suggests that statin therapy may be effective in reducing incident coronary events among those with elevated levels of C-reactive protein but normal levels of low-density lipoprotein cholesterol. These data, along with accumulating laboratory data, support a potential anti-inflammatory benefit of statins. Large-scale, randomized trials in the primary prevention of acute coronary events among individuals without overt hyperlipidemia but with evidence of elevated C-reactive protein are now needed to directly test this hypothesis.
Bermudez
Edmund A
EA
Center for Cardiovascular Disease Prevention, the Leducq Center for Cardiovascular Research, and the Divisions of Preventive Medicine and Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA.
Ridker
Paul M
PM
D000214:Acyl Coenzyme A / Q000627:therapeutic use*; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000187:drug effects* / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D011322:Primary Prevention
D000214:Acyl Coenzyme A; D015415:Biomarkers; D008078:Cholesterol, LDL; C008047:3-hydroxy-3-methylglutaryl-coenzyme A; D002097:C-Reactive Protein