PROVE-IT proves that lower is better: a contrary view.
Epidemiological studies have demonstrated that low density lipoprotein (LDL) cholesterol and C-reactive protein (CRP) are both independent risk factors for future cardiovascular events. Statin therapy, initially developed to modify blood lipid concentrations, has also been shown to have potentially important pleiotropic effects, including a reduction in CRP concentrations. Recent clinical trials have demonstrated conflicting results regarding the benefits associated with intensively lowering LDL cholesterol. An analysis of these results suggests that the different effects of specific statins on CRP concentrations may be an important determinant of the observed overall benefit associated with therapy. These studies together prove that while lowering LDL is beneficial, lowering LDL and CRP is better.
Centre for the Analysis of Cost-Effective Care and the Division of General Internal Medicine, The Montreal General Hospital, Montreal, Quebec. steven.grover@mcgill.ca
Steven A
SA
Grover
D050197:Atherosclerosis / Q000517:prevention & control; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood* / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein