Abstract 3864: Relationship Between Aspirin, Statins, the Combination and C-Reactive Protein
Background: Use of aspirin and statins reduces the risk for cardiovascular events. Both therapiesmodify inflammation; however, there is little data on whether they act in an additive or synergistic fashion.
Methods: The REasons for Geographic And Racial Differences in Stroke (REGARDS) is a national (US) longitudinal cohort study of community dwelling black or white adults above age 45. Aspirin and statin use, CRP and potential confounding factors were evaluated in either a telephone interview or in-home visit. To assess the association of aspirin and statin use (alone and in combination) with CRP multivariate adjustment was made for demographics, CVD risk factors, physical activity, and socioeconomic status.
Results: After excluding participants reporting chronic inflammatory conditions, use of NSAIDs > 2x/week or the chronic aspirin use for reasons other than cardioprotection, we assessed CRP levels among those using: statin only (n = 1898), aspirin only (n = 3673), both (n = 3008), neither (n = 7718). After multivariate adjustment use of statins alone (p < 0.0001) but not aspirin alone (p = 0.48) was associated with a lower CRP compared to non users. The combination was associated with apparent synergy, with a lower CRP than the additive effects of aspirin and statins alone (see figure⇓; p-value for interaction 0.01). Among subjects with CVD associations were larger.
Conclusion: In this cross-sectional study, combined use of aspirin and statin therapy was associated with a synergistically lower CRP concentration. The association was larger in those who report a history of CVD.