On-treatment C-reactive protein and HDL cholesterol levels in patients at intermediate cardiovascular risk: Impact on carotid intima-media thickness

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• 作者：Matteo Pirro ; Gaetano Vaudo ; Graziana Lupattelli ; Leonella Pasqualini ; Massimo R. Mannarino ; Giuseppe Schillaci ; Abdalkader Alaeddin ; Francesco Paciullo ; Francesca Fallarino ; Francesco Bagaglia ; Elmo Mannarino
• 关键词：Hypercholesterolemia ; C-reactive protein ; Statin ; Carotid ; Intima-media thickness ; Atherosclerosis
• 刊名：Life Sciences
• 出版年：2013
• 出版时间：3 September, 2013
• 年：2013
• 卷：93
• 期：8
• 页码：338-343
• 全文大小：385 K

文摘

Aims

Statin therapy is followed by reductions in carotid intima-media thickness (CIMT) and C-reactive protein (CRP) levels, but a significant number of treated patients still have increased CIMT. We investigated whether on-treatment levels of CRP are associated with CIMT in hypercholesterolemic patients receiving statin therapy. The influence of blood pressure and anti-hypertensive therapy on the association between CRP and CIMT was evaluated.

Main methods

The assessment of cardiovascular risk factors, CRP and CIMT, was performed in a cross-sectional study of 240 hypercholesterolemic patients at intermediate cardiovascular risk under statin therapy; 125 patients received only a statin (statin group) and 115 also anti-hypertensive therapy (combined therapy group).

Key findings

Logarithmically transformed CRP (¦Â = 0.17, p = 0.01) and HDL cholesterol levels (¦Â = ? 0.27, p < 0.001) were correlates of CIMT, irrespective of confounders. High CRP levels (> 3 mg/L) were associated with a 2.7-fold increased risk of having high CIMT (> 1.25 mm). High CIMT was present in a high percentage of patients not at target for cholesterol and blood pressure levels (61 % ). Patients in the statin group had lower Framingham risk and CIMT than those in the combined therapy group. In the statin group, logarithmically transformed CRP (¦Â = 0.28, p = 0.004) and HDL cholesterol (¦Â = ? 0.21, p = 0.03) were associated with CIMT. In the combined therapy group, HDL cholesterol was the only significant CIMT correlate (¦Â = ? 0.33, p = 0.001).

Significance

On-treatment CRP and HDL cholesterol levels are associated with CIMT among hypercholesterolemic patients under statin therapy. In patients receiving both statin and anti-hypertensive therapy, HDL cholesterol remains the main covariate of CIMT.