title: Inverse relationship between high-density lipoprotein cholesterol raising and high-sensitivity C-reactive protein reduction in older patients treated with lipid-lowering therapy.
abstract: BACKGROUND
  Little is known regarding relationships between high-sensitivity C-reactive protein (hsCRP) and lipoproteins other than low-density lipoprotein cholesterol (LDL-C). High-density lipoprotein (HDL), with both anti-inflammatory and cholesterol-mediating effects, is of particular interest. This exploratory analysis assessed associations between hsCRP and lipids in older (>65 years) patients with moderate and/or high cardiovascular disease risk, before and after treatment with ezetimibe/simvastatin (E/S) or atorvastatin (ATV).
  
  
  METHODS
  An analysis of a multicenter, randomized, double-blind, 12-week study. Correlations were assessed in 1054 patients with both baseline and 12-week hsCRP ≤ 10 mg/L, pooled across doses of E/S (10/20 and 10/40 mg) and ATV (10, 20, and 40 mg), and combined E/S + ATV treatments. Because of multiple comparisons, observed relationships were considered significant only if P values were < .01.
  
  
  RESULTS
  Correlations between baseline levels of hsCRP and either LDL-C, non-HDL-C, or apolipoprotein B were weak and nonsignificant in the E/S, ATV, and E/S + ATV groups. After 12 weeks of treatment, these correlations increased slightly and significantly in all groups, except for LDL-C in the ATV group. HDL-C was significantly but inversely correlated with hsCRP in the ATV and E/S + ATV groups at baseline, and in all groups at 12 weeks. Only with HDL-C did change correlate with change in hsCRP in both the E/S and combined groups.
  
  
  CONCLUSIONS
  Relationships between hsCRP and lipid factors in older patients were weak at baseline and somewhat stronger after treatment. HDL-C was inversely and consistently correlated with baseline and 12-week on-treatment hsCRP and with therapy-induced changes in HDL-C and hsCRP.
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA. Electronic address: wbrow925@bellsouth.net.
authors.forename: W Virgil
authors.initials: WV
authors.lastname: Brown
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: JoAnne M
authors.initials: JM
authors.lastname: Foody
authors.affiliation: McGuire VA Medical Center, Richmond, VA, USA.
authors.forename: Franklin J
authors.initials: FJ
authors.lastname: Zieve
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Tomassini
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: Arvind
authors.initials: A
authors.lastname: Shah
authors.affiliation: Merck & Co., Inc., Kenilworth, NJ, USA.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Tershakovec
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D001055:Apolipoproteins B / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D008076:Cholesterol, HDL / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D000924:Anticholesteremic Agents; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002097:C-Reactive Protein
keywords: Atorvastatin; Ezetimibe; HDL-C; Hypercholesterolemia; Vytorin; hsCRP