C-reactive protein, statins, and the primary prevention of atherosclerotic cardiovascular disease |
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Authors: | Bermudez Edmund A Ridker Paul M |
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Institution: | From the 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 |
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Abstract: | 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. |
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