Circulation. 2002;106:1447-1452
Published online before print August 26, 2002, doi: 10.1161/01.CIR.0000029743.68247.31
Published online before print August 26, 2002, doi: 10.1161/01.CIR.0000029743.68247.31
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(Circulation. 2002;106:1447.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Simvastatin Lowers C-Reactive Protein Within 14 Days
An Effect Independent of Low-Density Lipoprotein Cholesterol Reduction
From the Division of Endocrinology, Metabolism, and Diabetes (J.K.P., T.L.H., K.M.W., P.P., R.H.E.) and the Department of Preventive Medicine and Biometrics (G.K.G.), University of Colorado Health Sciences Center, Denver, Colo, and the Department of Medicine, Northwest Lipid Research Laboratories, University of Washington, Seattle, Wash (S.M.M.).
Correspondence to Robert H. Eckel, MD, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Health Sciences Center, 4200 East 9th Avenue, Box B151, Denver, CO 80262. E-mail robert.eckel{at}uchsc.edu
Background— The early response of C-reactive protein to initiation of a hydroxymethylglutaryl coenzyme A reductase inhibitor (statin) is not known. The purpose of this study was to determine the rate at which highly sensitive C-reactive protein (hsCRP) levels change after initiation of simvastatin and whether this occurs independently of the change in LDL cholesterol.
Methods and Results— The study was a crossover, double-blind design including 40 subjects with elevated LDL cholesterol. Subjects were randomly assigned to 1 of 2 groups: simvastatin 40 mg for 14 days, then placebo for 14 days, or placebo first, then simvastatin. Simvastatin decreased LDL cholesterol by 56±4 mg/dL (P<0.0001) at day 7 and by an additional 8±3 mg/dL (P=0.02) at day 14. Baseline log(hsCRP) levels were similar in the 2 groups. By day 14, log(hsCRP) was significantly lower in patients on simvastatin when compared with placebo (P=0.011). Although there was no significant difference in fibrinogen levels, simvastatin produced a modest increase in log[lipoprotein(a)] (P=0.03) at days 7 and 14. There were no relationships between the decrease in LDL cholesterol and the decrease in hsCRP.
Conclusions— Simvastatin lowers hsCRP by 14 days, independent of its effect on LDL cholesterol. This rapid impact of a statin on hsCRP has potential implications in the management of acute coronary syndromes.
Key Words: C-reactive protein • lipoproteins • fibrinogen • inflammation
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