title: Usefulness of C-reactive protein and interleukin-6 as predictors of outcomes in patients with chronic obstructive pulmonary disease receiving pravastatin.
abstract: Inflammation is increased in chronic obstructive pulmonary disease (COPD) and plays a role in exercise intolerance. We investigated whether pravastatin administration is effective in improving exercise capacity in patients with COPD, and whether baseline or serial changes in high-sensitivity C-reactive protein (hs-CRP) over time are associated with corresponding changes in exercise capacity. In a randomized, double-blinded, and parallel design, 125 patients with clinically stable COPD were randomly assigned to receive placebo or pravastatin (40 mg/day) over a period of 6 months. Plasma hs-CRP levels were measured before randomization and during follow-up. Baseline characteristics were similar in the 2 groups. Exercise time remained stable throughout the study in the placebo group. Exercise time increased by 54% from 599 +/- 323 seconds at baseline to 922 +/- 328 seconds at the end (p <0.0001) in pravastatin-treated patients. A decrease in hs-CRP over baseline values was observed in 79% of patients (42 of 53) treated with pravastatin. Pravastatin-treated patients with a greater percent decrease in hs-CRP had a significant improvement in exercise time compared with those without hs-CRP decrease. A significant correlation was found in univariate analysis between decrease of log-transformed hs-CRP and increase of exercise time. Baseline hs-CRP and change of hs-CRP were significantly correlated with exercise time, even after adjustment for lipid profiles and hemodynamics. In conclusion, these data reinforce hs-CRP as a significant surrogate marker in COPD and underscore an important guide to the efficacy of treatment in COPD trials.
authors.affiliation: Cardiology Section, Department of Medicine, Taipei Medical University and Chi-Mei Medical Center, Tainan, Taiwan.
authors.forename: Tsung-Ming
authors.initials: TM
authors.lastname: Lee
authors.forename: Mei-Shu
authors.initials: MS
authors.lastname: Lin
authors.forename: Nen-Chung
authors.initials: NC
authors.lastname: Chang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D004311:Double-Blind Method; D004417:Dyspnea / Q000188:drug therapy / Q000209:etiology; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D017035:Pravastatin / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy*
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015850:Interleukin-6; D002097:C-Reactive Protein; D002784:Cholesterol; D017035:Pravastatin