title: An assessment of the joint associations of aspirin and statin use with C-reactive protein concentration.
abstract: BACKGROUND
  The use of aspirin alone and statins alone has been shown to reduce markers of inflammation, including C-reactive protein (CRP); however, their combination has been poorly studied.
  
  
  METHODS
  In a cross-sectional analysis of black and white adults > or =45 years old from the REGARDS cohort, the associations of aspirin and statin use with CRP were examined. Individuals requiring nonsteroidal anti-inflammatory drug therapy or those taking aspirin for reasons other than cardioprotection were excluded from analysis. Participants were classified into 1 of 4 groups: aspirin only (n = 3,673), statin only (n = 1,898), both agents (n = 3,008), or neither agent (n = 7,718).
  
  
  RESULTS
  Estimated mean CRP was 2.78 mg/L for subjects taking neither drug, 2.73 mg/L with aspirin only, 2.29 mg/L with statins only, and 2.03 mg/L for subjects taking both agents. The combined use of both agents was associated with an apparent synergistically lower CRP; the mean CRP level among these combined users was 0.21 mg/L lower than that anticipated from additive association related to aspirin and statins alone (P for interaction = .01). Associations were larger among participants reporting a history of cardiovascular disease. In addition, among statin users, the use of aspirin for >5 years compared with < or =5 years was associated with apparent significantly lower CRP concentrations (P = .01).
  
  
  CONCLUSIONS
  The combined use of aspirin and statins was associated with a synergistically lower CRP concentration, especially among participants taking aspirin for >5 years. Given the limitations of this study and the modest associations, randomized controlled trial evidence is needed to confirm the findings.
authors.affiliation: Bayer HealthCare, Morristown, NJ 07962-1910, USA. matt.fisher.b@bayer.com
authors.forename: Matt
authors.initials: M
authors.lastname: Fisher
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: Volker
authors.initials: V
authors.lastname: Knappertz
authors.forename: George
authors.initials: G
authors.lastname: Howard
mesh_terms: D000368:Aged; D001241:Aspirin / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000187:drug effects* / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D002097:C-Reactive Protein; D001241:Aspirin