摘要
背景：人体血清C反应蛋白(C-reactive protein, CRP)升高是心血管事件的独立预测因子。高敏C反应蛋白(high sensitivity CRP, hsCRP)是使用高敏感的检测方法,对CRP的进行精确定量,从而更加准确的预测心血管事件。但是截至目前,还没有关于hsCRP与冠状动脉旁路移植手术中远期预后的相关性研究。本文将回顾性分析术前hsCRP对近期和中期预后的预测作用。
方法：本研究入选了从2006年1月1日到2007年12月31日在阜外心血管病医院行单纯冠状动脉旁路移植手术(CABG)的冠心病患者,分析术前hsCRP水平与近期、中期预后的相关关系,并寻找合理的危险分层界值,最后采用多因素回归模型研究hsCRP升高对近期、中期预后的独立危险作用。近期预后终点为院内死亡、术后主要并发症。中期预后终点为(全因)死亡、主要不良心血管事件(MACE)和充血性心力衰竭(心衰)。
结果：研究期间共有3236名患者接受CABG,其中373名患者术前未检测hsCRP而被排除,最终2863名患者入选本研究。住院期间,死亡患者为26名(0.9%),发生术后主要并发症患者288名(10.1%)。术后随访3.6年(平均1.7年),成功随访到2826名患者(随访率为99.6%),其中死亡患者56名(2.0%),发生MACE患者105名(3.7%),发生心衰患者70名(2.5%)。分析显示,术前hsCRP每升高1mg/L,发生院内死亡(OR=2.50,p=0.002)、术后主要并发症(OR=1.38,p=0.02)、中期死亡(HR=1.68,p=0.03)、主要不良心血管事件(MACE)(HR=1.48, p=0.04)和心衰(HR=1.88,p=0.01)的风险均显著增加。进一步分析表明hsCRP=2.5mg/L是本研究中CABG患者危险分层的理想界值。术前hsCRP升高患者(hsCRP>2.5mg/L, n=1070)的院内死亡、术后主要并发症、中期死亡、MACE和心衰发生率均显著高于术前hsCRP未升高的患者(hsCRP≤2.5mg/L,n=1793)。校正其他因素后,hsCRP>2.5mg/L是院内死亡(p=0.02,HR=2.55)、术后主要并发症(p=0.004,HR=1.46)、中期死亡p=0.02, HR=1.92)、MACE(p<0.001, HR=2.06)和心衰(p=0.03,HR=1.71)的独立危险因素。
结论：术前hsCRP水平与冠状动脉旁路移植手术预后显著相关,hsCRP升高(hsCRP>2.5mg/L)是近期和中期预后的独立危险因素。hsCRP应该在冠状动脉旁路移植手术患者的危险分层中应用。
背景：他汀类药物的抗炎作用在冠心的一级预防和二级预防中极为重要。在血脂水平正常的健康人群中,他汀类药物可以显著降低高炎症状态(CRP升高)患者的心血管事件发生率和死亡率,可是在低炎症状态人群中,这种保护作用并不明显。但目前还没有关于冠心病患者的类似报道。本研究将探索他汀类药物对于不同炎症状态冠状动脉旁路移植手术(CABG)患者的心血管事件保护作用是否存在差异。
方法：本研究分析了从2006年1月1日到2007年12月31日在阜外心血管病医院行单纯冠状动脉旁路移植手术并存活出院的冠心病患者,按照本文第一部分获得的hsCRP界值(2.5mg/L)将其分为高、低炎症状态两组,再以术后是否长期服用他汀类药物进行亚组划分,分析他汀类药物对各亚组的中期预后保护作用。中期预后终点为(全因)死亡、主要不良心血管事件(MACE)和充血性心力衰竭(心衰)。
结果：根据本文第一部分,共有2837名患者入选本研究。在高炎症状态组(n=1054),术后长期服用他汀类药物患者的死亡率(0.74%vs5.28%,p<0.001)、MACE发生率(3.31%vs7.05%,p=0.003)和心衰发生率(2.03%vs4.89%,p=0.01)均显著低于未长期服用他汀类药物组。但对于低炎症状态组(n=1783),死亡率(0.97%vs2.00%, p=0.10)、MACE发生率(3.29%vs2.27%,p=0.20)、心衰发生率(1.94%vs1.87%,p=0.98)没有差异。经过校正其他因素,术后长期服用他汀类药物可以降低高炎症状态患者的死亡风险64%(HR=0.36,p=0.002,95%CI=0.25-0.70),降低MACE风险54%(HR=0.46,p=0.01,95%CI=0.25-0.82),降低心衰风险69%(HR=0.31, p=0.003,95%CI=0.14-0.66)。但对于低炎症状态患者,术后长期服用他汀类药物对死亡(HR=0.53,p=0.12,95%CI=0.24-1.18)、MACE (HR=1.10, p=0.75,95%CI=0.60-2.04)、心衰(HR=1.35, p=0.42,95%CI=0.65-2.82)的作用无统计学意义。
结论：术后长期服用他汀类药物对术前高炎症状态(hsCRP>2.5mg/L)患者的中期预后有保护作用,可以显著降低死亡、MACE和心衰的发生风险。而对于术前低炎症状态(hsCRP≤2.5mg/L)患者,术后长期服用他汀类药物对中期预后的影响并不明显。
Background—Elevated C-reactive protein (CRP) is a powerful independent predictor of cardiovascular events in the healthy population and in patients with coronary artery disease. High-sensitive C-Reactive Protein (hsCRP) is precise and sensitive for quantification of CRP. But to date, there is no date on its impact on overall mid-term and late outcomes after coronary artery bypass grafting (CABG). The study objective was to evaluate the effect of hsCRP on early and mid-term outcome after CABG
Methods—We have investigated the relationship of preoperative hsCRP with early and mid-term outcomes of all the patients who underwent isolated CABG between1st January2006and31st December2007in Fuwai Hospital. Then we tried to get an optimal cut off value of hsCRP for risk stratification and estimate the effect of elevated hsCRP on the early and mid-term outcomes by multivariable regression analysis. Early endpoints were in-hospital mortality and postoperative major morbidity. Mid-term endpoints were overall mortality, major adverse cardiovascular events (MACE) and new onset heart failure.
Result—In2863of3236cases, the preoperative C-reactive protein level could be retrieved. During the in-hospital stay,26patients died (0.9%) and288patients suffered postoperative major morbidity (10.1%). Among operative survivors,11patients were unavailable for follow-up. At3.6year follow-up,56patients died (2.0%),105patients had MACE (3.7%) and70patients developed heart failure (2.5%). We found that every lmg/L uprising for hsCRP was associated with increased odds ratio (OR) for early mortality (OR=2.50, p=0.002), postoperative major morbidity (OR=1.38, p=0.02), and raised hazard ratio (HR) for mid-term mortality (HR=1.68, p=0.03), MACE (HR=1.48, p=0.04) and heart failure (HR=1.88,p=0.01). Further analysis showed that hsCRP=2.5mg/L was the best cutoff value for risk stratification in terms of both early and mid-term outcomes of CABG The patients whose preoperative hsCRP levels were elevated (>2.5mg/L, n=1070) suffered significantly increased early mortality (1.50%vs0.56%, p=0.01), major morbidity (12.71%vs8.48%, p<0.001), mid-term mortality (2.94%vs1.40%, p=0.01), MACE (5.12%vs2.86%,p=0.003) and heart failure (3.42%vs1.91%,p=0.02) than those whose preoperative hsCRP≤2.5mg/L (n=1793). Multivariate analysis revealed that preoperative hsCRP>2.5mg/L was an independent risk factor of both early (p=0.02, HR=2.55) and mid-term mortality (p=0.02, HR=1.92), postoperative major morbidity (p=0.004, HR=1.46), mid-term MACE (p<0.001, HR=2.06) and heart failure (p=0.03, HR=1.71).
Conclusions—Preoperative hsCRP levels were significantly correlated with outcomes of CABG Elevated levels of hsCRP (>2.5mg/L) predict an increased risk of early and mid-term outcome after CABG. CRP levels should be taken into account for risk stratification in CABG.
Background—Landmark clinical trials have demonstrated the prominent protective value of anti-inflammatory effect of statins on primary and secondary prevention of coronary artery diseases. In health people with average levels of total and LDL cholesterol, statins showed significant primary prevention effect for the group with elevated C reactive protein (CRP), but not for those without elevated CRP. However, no studies have addressed the issue that if patients with different inflammatory level might derive similar benefit from continuous statin treatment after coronary artery bypass grafting surgery (CABG). Therefore, we evaluated the effect of continuous statin treatment on late outcomes of patients with different CRP levels after CABG.
Methods—This retrospective cohort study enrolled all the patients who underwent isolated CABG and survived to discharge between1st January2006and31st December2007in Fuwai Hospital, and was divided into two groups according to cut-off value of preoperative hsCRP (2.5mg/L) obtained in PART I. Then we evaluated the relations between postoperative continuous statin therapy and mid-term outcomes for both groups. Mid-term endpoints were overall mortality, major adverse cardiovascular events (MACE) and congestive heart failure.
Result—According to PART I,2837patients were analyzed in this study. For the group of preoperative hsCRP>2.5mg/L, patients who took postoperative continuous statin therapy had remarkably reduced the mid-term incidences of death (0.74%vs5.28%,p<0.001), MACE (3.31%vs7.05%, p=0.003) and heart failure (2.03%vs4.89%, p=0.01) compared with those did not take persistent statins. For the group of preoperative hsCRP≤2.5mg/L, patients with postoperative continuous statin therapy had similar mid-term incidences of death (0.97%vs2.00%, p=0.10), MACE (3.29%vs2.27%, p=0.20) and heart failure (1.94%vs1.87%, p=0.98) compared with those did not take persistent statins. After adjusted for other variables, continuous statin therapy remarkably reduced risk of mid-term mortality by64%(HR=0.36,p=0.002,95%CI=0.25-0.70), MACE by54%(HR=0.46, p=0.01,95%CI=0.25-0.82) and heart failure by69%(HR=0.31,p=0.003, 95%CI=0.14-0.66) for patients with preoperative hsCRP>2.5mg/L. However, this protective effect was not statistically significant for mid-term mortality (HR=0.53,p=0.12,95%CI=0.24-1.18), MACE (HR=1.10, p=0.75,95%CI=0.60-2.04) and heart failure (HR=1.35,p=0.42,95%CI=0.65-2.82) among patients whose preoperative hsCRP≤2.5mg/L.
Conclusions—Postoperative continuous statin therapy could significantly reduced the mid-term incidences of death, MACE, heart failure for patients with elevated preoperative levels of hsCRP(>2.5mg/L). Whereas, this protective effect was not statistically significant among patients whose preoperative levels of hsCRP≤2.5mg/L.
引文
1. Lind, L. Circulating markers of inflammation and atherosclerosis [J]. Atherosclerosis,2003, 169(2):203-14.
2. Ross, R. Atherosclerosis--an inflammatory disease [J]. N Engl J Med,1999,340(2):115-26.
3. Drakopoulou, M., K. Toutouzas, E. Stefanadi, et al. Association of inflammatory markers with angiographic severity and extent of coronary artery disease [J]. Atherosclerosis,2009, 206(2):335-9.
4. Park, D.W., C.W. Lee, S.C. Yun, et al. Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation [J]. Heart,2007,93(9):1087-92.
5. Ridker, P.M. High-sensitivity C-reactive protein:potential adjunct for global risk assessment in the primary prevention of cardiovascular disease [J]. Circulation,2001,103(13):1813-8.
6. Ridker, P.M., M.J. Stampfer, and N. Rifai. Novel risk factors for systemic atherosclerosis:a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease [J]. JAMA,2001,285(19): 2481-5.
7. Danesh, J., J.G. Wheeler, G.M. Hirschfield, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease [J]. N Engl J Med,2004, 350(14):1387-97.
8. Ridker, P.M., N. Rifai, L. Rose, et al. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events [J]. N Engl J Med,2002,347(20):1557-65.
9. Ridker, P.M., C.H. Hennekens, J.E. Buring, et al. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women [J]. N Engl J Med,2000, 342(12):836-43.
10. Zebrack, J.S., J.L. Anderson, C.A. Maycock, et al. Usefulness of high-sensitivity C-reactive protein in predicting long-term risk of death or acute myocardial infarction in patients with unstable or stable angina pectoris or acute myocardial infarction [J]. Am J Cardiol,2002, 89(2):145-9.
11. Ridker, P.M., C.P. Cannon, D. Morrow, et al. C-reactive protein levels and outcomes after statin therapy [J]. N Engl J Med,2005,352(1):20-8.
12. Liuzzo, G, L.M. Biasucci, J.R. Gallimore, et al. The prognostic value of C-reactive protein and serum amyloid a protein in severe unstable angina [J]. N Engl J Med,1994,331(7): 417-24.
13. Yin, W.H., J.W. Chen, H.L. Jen, et al. Independent prognostic value of elevated high-sensitivity C-reactive protein in chronic heart failure [J]. Am Heart J,2004,147(5): 931-8.
14. Buffon, A., G Liuzzo, L.M. Biasucci, et al. Preprocedural serum levels of C-reactive protein predict early complications and late restenosis after coronary angioplasty [J]. J Am Coll Cardiol,1999,34(5):1512-21.
15. Walter, D.H., S. Fichtlscherer, M. Sellwig, et al. Preprocedural C-reactive protein levels and cardiovascular events after coronary stent implantation [J]. J Am Coll Cardiol,2001,37(3): 839-46.
16. Pearson, T.A., G.A. Mensah, R.W. Alexander, et al. Markers of inflammation and cardiovascular disease:application to clinical and public health practice:A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association [J]. Circulation,2003,107(3):499-511.
17. Hennein, H.A., H. Ebba, J.L. Rodriguez, et al. Relationship of the proinflammatory cytokines to myocardial ischemia and dysfunction after uncomplicated coronary revascularization [J]. J Thorac Cardiovasc Surg,1994,108(4):626-35.
18. Parolari, A., M. Camera, F. Alamanni, et al. Systemic inflammation after on-pump and off-pump coronary bypass surgery:a one-month follow-up [J]. Ann Thorac Surg,2007,84(3): 823-8.
19. van Straten, A.H., M.A. Soliman Hamad, A.J. van Zundert, et al. Preoperative C-reactive protein levels to predict early and late mortalities after coronary artery bypass surgery:eight years of follow-up [J]. J Thorac Cardiovasc Surg,2009,138(4):954-8.
20. Balciunas, M., L. Bagdonaite, R. Samalavicius, et al. Pre-operative high sensitive C-reactive protein predicts cardiovascular events after coronary artery bypass grafting surgery:a prospective observational study [J]. Ann Card Anaesth,2009,12(2):127-32.
21. Palmerini, T., A. Marzocchi, C. Marrozzini, et al. Preoperative C-reactive protein levels predict 9-month mortality after coronary artery bypass grafting surgery for the treatment of left main coronary artery stenosis [J]. Eur J Cardiothorac Surg,2007,31(4):685-90.
22. Kangasniemi, O.P., F. Biancari, J. Luukkonen, et al. Preoperative C-reactive protein is predictive of long-term outcome after coronary artery bypass surgery [J]. Eur J Cardiothorac Surg,2006,29(6):983-5.
23. Cappabianca, G., D. Paparella, G. Visicchio, et al. Preoperative C-reactive protein predicts mid-term outcome after cardiac surgery [J]. Ann Thorac Surg,2006,82(6):2170-8.
24. Biancari, F., J. Lahtinen, S. Lepojarvi, et al. Preoperative C-reactive protein and outcome after coronary artery bypass surgery [J]. Ann Thorac Surg,2003,76(6):2007-12.
25. Gaudino, M., G Nasso, F. Andreotti, et al. Preoperative C-reactive protein level and outcome following coronary surgery [J]. Eur J Cardiothorac Surg,2002,22(4):521-6.
26. Kim, D.H., J.K. Shim, S.W. Hong, et al. Predictive value of C-reactive protein for major postoperative complications following off-pump coronary artery bypass surgery:prospective and observational trial [J]. Circ J,2009,73(5):872-7.
27. Ridker, P.M., M. Cushman, M.J. Stampfer, et al. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men [J]. N Engl J Med,1997,336(14):973-9.
28. Roberts, W.L., R. Sedrick, L. Moulton, et al. Evaluation of four automated high-sensitivity C-reactive protein methods:implications for clinical and epidemiological applications [J]. Clin Chem,2000,46(4):461-8.
29. Li, Y., Z. Zheng, and S. Hu. The Chinese coronary artery bypass grafting registry study: analysis of the national multicentre database of 9248 patients [J]. Heart,2009,95(14): 1140-4.
30. Garrow, J.S. and J. Webster. Quetelet's index (W/H2) as a measure of fatness [J]. Int J Obes, 1985,9(2):147-53.
31. Kopjar, B., A.E. Sales, S.L. Pineros, et al. Adherence with statin therapy in secondary prevention of coronary heart disease in veterans administration male population [J]. Am J Cardiol,2003,92(9):1106-8.
32. Gehi, A.K., S. Ali, B. Na, et al. Self-reported medication adherence and cardiovascular events in patients with stable coronary heart disease:the heart and soul study [J]. Arch Intern Med, 2007,167(16):1798-803.
33. Perreault, S., A. Dragomir, L. Roy, et al. Adherence level of antihypertensive agents in coronary artery disease [J]. Br J Clin Pharmacol,2010,69(1):74-84.
34. Benner, J.S., R.J. Glynn, H. Mogun, et al. Long-term persistence in use of statin therapy in elderly patients [J]. JAMA,2002,288(4):455-61.
35. 高华炜,郑哲,胡盛寿.冠状动脉旁路移植术危险因素评价体系的建立及应用[J].中华胸心血管外科杂志,2006,22(3)：214-216.
36. Zheng, Z., Y. Li, S. Zhang, et al. The Chinese coronary artery bypass grafting registry study: how well does the EuroSCORE predict operative risk for Chinese population? [J]. Eur J Cardiothorac Surg,2009,35(1):54-8.
37. Nashef, S.A., F. Roques, P. Michel, et al. European system for cardiac operative risk evaluation (EuroSCORE) [J]. Eur J Cardiothorac Surg,1999,16(1):9-13.
38. Shahian, D.M., S.M. O'Brien, G Filardo, et al. The Society of Thoracic Surgeons 2008 cardiac surgery risk models:part l--oronary artery bypass grafting surgery [J]. Ann Thorac Surg,2009,88(1 Suppl):S2-22.
39. Madan, P., M.A. Elayda, V.V. Lee, et al. Predicting major adverse cardiac events after percutaneous coronary intervention:the Texas Heart Institute risk score [J]. Am Heart J,2008, 155(6):1068-74.
40. Kardys, I., A.M. Knetsch, G.S. Bleumink, et al. C-reactive protein and risk of heart failure. The Rotterdam Study [J]. Am Heart J,2006,152(3):514-20.
41. Anderson, R.P. First publications from the Society of Thoracic Surgeons National Database [J]. Ann Thorac Surg,1994,57(1):6-7.
42. Ablij, H. and A. Meinders. C-reactive protein:history and revival [J]. Eur J Intern Med,2002, 13(7):412.
43. Verma, S., M.V. Badiwala, R.D. Weisel, et al. C-reactive protein activates the nuclear factor-kappaB signal transduction pathway in saphenous vein endothelial cells:implications for atherosclerosis and restenosis [J]. J Thorac Cardiovasc Surg,2003,126(6):1886-91.
44. Ballou, S.P. and G. Lozanski. Induction of inflammatory cytokine release from cultured human monocytes by C-reactive protein [J]. Cytokine,1992,4(5):361-8.
45. Zwaka, T.P., V. Hombach, and J. Torzewski. C-reactive protein-mediated low density lipoprotein uptake by macrophages:implications for atherosclerosis [J]. Circulation,2001, 103(9):1194-7.
46. Moor, E., M. Blomback, A. Silveira, et al. Haemostatic function in patients undergoing coronary artery bypass grafting:peroperative perturbations and relations to saphenous vein graft closure [J]. Thromb Res,2000,98(1):39-49.
47. Danenberg, H.D., A.J. Szalai, R.V. Swaminathan, et al. Increased thrombosis after arterial injury in human C-reactive protein-transgenic mice [J]. Circulation,2003,108(5):512-5.
48. Williams, T.N., C.X. Zhang, B.A. Game, et al. C-reactive protein stimulates MMP-1 expression in U937 histiocytes through Fc[gamma]RII and extracellular signal-regulated kinase pathway::an implication of CRP involvement in plaque destabilization [J]. Arterioscler Thromb Vasc Biol,2004,24(1):61-6.
49. Montero, I., J. Orbe, N. Varo, et al. C-reactive protein induces matrix metalloproteinase-1 and-10 in human endothelial cells:implications for clinical and subclinical atherosclerosis [J]. J Am Coll Cardiol,2006,47(7):1369-78.
50. Ridker, P.M. Clinical application of C-reactive protein for cardiovascular disease detection and prevention [J]. Circulation,2003,107(3):363-9.
51. Suleiman, M., R. Khatib, Y. Agmon, et al. Early inflammation and risk of long-term development of heart failure and mortality in survivors of acute myocardial infarction predictive role of C-reactive protein [J]. J Am Coll Cardiol,2006,47(5):962-8.
52. Kinjo, K., H. Sato, Y. Ohnishi, et al. Impact of high-sensitivity C-reactive protein on predicting long-term mortality of acute myocardial infarction [J]. Am J Cardiol,2003,91(8): 931-5.
53. Vasan, R.S., L.M. Sullivan, R. Roubenoff, et al. Inflammatory markers and risk of heart failure in elderly subjects without prior myocardial infarction:the Framingham Heart Study [J]. Circulation,2003,107(11):1486-91.
54. Bursi, F., S.A. Weston, J.M. Killian, et al. C-reactive protein and heart failure after myocardial infarction in the community [J]. Am J Med,2007,120(7):616-22.
55. Torre-Amione, G., S. Kapadia, C. Benedict, et al. Proinflammatory cytokine levels in patients with depressed left ventricular ejection fraction:a report from the Studies of Left Ventricular Dysfunction (SOLVD) [J]. J Am Coll Cardiol,1996,27(5):1201-6.
56. Griselli, M., J. Herbert, W.L. Hutchinson, et al. C-reactive protein and complement are important mediators of tissue damage in acute myocardial infarction [J]. J Exp Med,1999, 190(12):1733-40.
57. Barrett, T.D., J.K. Hennan, R.M. Marks, et al. C-reactive-protein-associated increase in myocardial infarct size after ischemia/reperfusion [J]. J Pharmacol Exp Ther,2002,303(3): 1007-13.
58. van der Harst, P., A.A. Voors, M. Volbeda, et al. Usefulness of preoperative C-reactive protein and soluble intercellular adhesion molecule-1 level for predicting future cardiovascular events after coronary artery bypass grafting [J]. Am J Cardiol,2006,97(12):1697-701.
59. Shroyer, A.L., L.P. Coombs, E.D. Peterson, et al. The Society of Thoracic Surgeons:30-day operative mortality and morbidity risk models [J]. Ann Thorac Surg,2003,75(6):1856-64; discussion 1864-5.
60. Clark, L.L., J.S. Ikonomidis, F.A. Crawford, Jr., et al. Preoperative statin treatment is associated with reduced postoperative mortality and morbidity in patients undergoing cardiac surgery:an 8-year retrospective cohort study [J]. J Thorac Cardiovasc Surg,2006,131(3): 679-85.
61. Ye, X., Z. Yu, H. Li, et al. Distributions of C-reactive protein and its association with metabolic syndrome in middle-aged and older Chinese people [J]. J Am Coll Cardiol,2007, 49(17):1798-805.
1. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals:a randomised placebo-controlled trial [J]. Lancet,2002,360(9326): 7-22.
2. Ridker, P.M., N. Rifai, M. Clearfield, et al. Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events [J]. N Engl J Med,2001,344(26):1959-65.
3. Shepherd, J., J.J. Kastelein, V. Bittner, et al. Intensive lipid lowering with atorvastatin in patients with coronary heart disease and chronic kidney disease:the TNT (Treating to New Targets) study [J]. J Am Coll Cardiol,2008,51(15):1448-54.
4. Flaker, G.C., J.W. Warnica, F.M. Sacks, et al. Pravastatin prevents clinical events in revascularized patients with average cholesterol concentrations. Cholesterol and Recurrent Events CARE Investigators [J]. J Am Coll Cardiol,1999,34(1):106-12.
5. Halcox, J.P. and J.E. Deanfield. Beyond the laboratory:clinical implications for statin pleiotropy [J]. Circulation,2004,109(21 Suppl 1):II42-8.
6. Ridker, P.M., N. Rifai, M.A. Pfeffer, et al. Long-term effects of pravastatin on plasma concentration of C-reactive protein. The Cholesterol and Recurrent Events (CARE) Investigators [J]. Circulation,1999,100(3):230-5.
7. Kaul, P., Y. Fu, W.C. Chang, et al. Prognostic value of ST segment depression in acute coronary syndromes:insights from PARAGON-A applied to GUSTO-IIb. PARAGON-A and GUSTO IIb Investigators. Platelet IIb/IIIa Antagonism for the Reduction of Acute Global Organization Network [J]. J Am Coll Cardiol,2001,38(1):64-71.
8. Albert, M.A., E. Danielson, N. Rifai, et al. Effect of statin therapy on C-reactive protein levels:the pravastatin inflammation/CRP evaluation (PRINCE):a randomized trial and cohort study [J]. JAMA,2001,286(1):64-70.
9. Chan, A.W., D.L. Bhatt, D.P. Chew, et al. Relation of inflammation and benefit of statins after percutaneous coronary interventions [J]. Circulation,2003,107(13):1750-6.
10. Morrow, D.A., J.A. de Lemos, M.S. Sabatine, et al. Clinical relevance of C-reactive protein during follow-up of patients with acute coronary syndromes in the Aggrastat-to-Zocor Trial [J]. Circulation,2006,114(4):281-8.
11. Ridker, P.M., E. Danielson, F.A. Fonseca, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein [J]. N Engl J Med,2008,359(21): 2195-207.
12. The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts. The Post Coronary Artery Bypass Graft Trial Investigators [J]. N Engl J Med,1997,336(3): 153-62.
13. Knatterud, G.L., Y. Rosenberg, L. Campeau, et al. Long-term effects on clinical outcomes of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation in the post coronary artery bypass graft trial. Post CABG Investigators [J]. Circulation,2000,102(2):157-65.
14. Li, Y., Z. Zheng, and S. Hu. The Chinese coronary artery bypass grafting registry study: analysis of the national multicentre database of 9248 patients [J]. Heart,2009,95(14): 1140-4.
15. Maddox, T.M. and P.M. Ho. Medication adherence and the patient with coronary artery disease:challenges for the practitioner [J]. Curr Opin Cardiol,2009,24(5):468-72.
16. Kopjar, B., A.E. Sales, S.L. Pineros, et al. Adherence with statin therapy in secondary prevention of coronary heart disease in veterans administration male population [J]. Am J Cardiol,2003,92(9):1106-8.
17. Osterberg, L. and T. Blaschke. Adherence to medication [J]. N Engl J Med,2005,353(5): 487-97.
18. Garrow, J.S. and J. Webster. Quetelet's index (W/H2) as a measure of fatness [J]. Int J Obes, 1985,9(2):147-53.
19. Gehi, A.K., S. Ali, B. Na, et al. Self-reported medication adherence and cardiovascular events in patients with stable coronary heart disease:the heart and soul study [J]. Arch Intern Med, 2007,167(16):1798-803.
20. Newby, L.K., N.M. LaPointe, A.Y. Chen, et al. Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease [J]. Circulation,2006,113(2): 203-12.
21. Perreault, S., A. Dragomir, L. Roy, et al. Adherence level of antihypertensive agents in coronary artery disease [J]. Br J Clin Pharmacol,2010,69(1):74-84.
22. Benner, J.S., R.J. Glynn, H. Mogun, et al. Long-term persistence in use of statin therapy in elderly patients [J]. JAMA,2002,288(4):455-61.
23. Cutlip, D.E., S. Windecker, R. Mehran, et al. Clinical end points in coronary stent trials:a case for standardized definitions [J]. Circulation,2007,115(17):2344-51.
24. Kardys, I., A.M. Knetsch, G.S. Bleumink, et al. C-reactive protein and risk of heart failure. The Rotterdam Study [J]. Am Heart J,2006,152(3):514-20.
25. Morisky, D.E., L.W. Green, and D.M. Levine. Concurrent and predictive validity of a self-reported measure of medication adherence [J]. Med Care,1986,24(1):67-74.
26. Ghali, J.K., S. Kadakia, R. Cooper, et al. Precipitating factors leading to decompensation of heart failure. Traits among urban blacks [J]. Arch Intern Med,1988,148(9):2013-6.
27. Blumberg, E.J., M.F. Hovell, N.J. Kelley, et al. Self-report INH adherence measures were reliable and valid in Latino adolescents with latent tuberculosis infection [J]. J Clin Epidemiol,2005,58(6):645-8.
28. Grundy, S.M., J.I. Cleeman, C.N. Merz, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines [J]. Circulation, 2004,110(2):227-39.
29. De Backer, G., E. Ambrosioni, K. Borch-Johnsen, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice [J]. Eur Heart J, 2003,24(17):1601-10.
30. Kimura, M., I. Kurose, J. Russell, et al. Effects of fluvastatin on leukocyte-endothelial cell adhesion in hypercholesterolemic rats [J]. Arterioscler Thromb Vasc Biol,1997,17(8): 1521-6.
31. Harker, L.A., R. Ross, S.J. Slichter, et al. Homocystine-induced arteriosclerosis. The role of endothelial cell injury and platelet response in its genesis [J]. J Clin Invest,1976,58(3): 731-41.
32. Lind, L. Circulating markers of inflammation and atherosclerosis [J]. Atherosclerosis,2003, 169(2):203-14.
33. Ross, R. Atherosclerosis-an inflammatory disease [J]. N Engl J Med,1999,340(2):115-26.
34. Drakopoulou, M., K. Toutouzas, E. Stefanadi, et al. Association of inflammatory markers with angiographic severity and extent of coronary artery disease [J]. Atherosclerosis,2009, 206(2):335-9.
35. Park, D.W., C.W. Lee, S.C. Yun, et al. Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation [J]. Heart,2007,93(9):1087-92.
36. Hansson, GK. Inflammation, atherosclerosis, and coronary artery disease [J]. N Engl J Med, 2005,352(16):1685-95.
37. Strandberg, T.E., H. Vanhanen, and M.J. Tikkanen. Effect of statins on C-reactive protein in patients with coronary artery disease [J]. Lancet,1999,353(9147):118-9.
38. Shalev, V., G Chodick, H. Silber, et al. Continuation of statin treatment and all-cause mortality:a population-based cohort study [J]. Arch Intern Med,2009,169(3):260-8.
39. Ridker, P.M., N. Rifai, L. Rose, et al. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events [J]. N Engl J Med,2002,347(20):1557-65.
40. Cannon, C.P., E, Braunwald, C.H. McCabe, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes [J]. N Engl J Med,2004,350(15):1495-504.
41. Schwartz, G.G., A.G Olsson, M.D. Ezekowitz, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes:the MIRACL study:a randomized controlled trial [J]. JAMA,2001,285(13):1711-8.
42. Kjekshus, J., T.R. Pedersen, A.G Olsson, et al. The effects of simvastatin on the incidence of heart failure in patients with coronary heart disease [J]. J Card Fail,1997,3(4):249-54.
43. Gaudino, M., G. Nasso, F. Andreotti, et al. Preoperative C-reactive protein level and outcome following coronary surgery [J]. Eur J Cardiothorac Surg,2002,22(4):521-6.
44. Cappabianca, G, D. Paparella, G. Visicchio, et al. Preoperative C-reactive protein predicts mid-term outcome after cardiac surgery [J]. Ann Thorac Surg,2006,82(6):2170-8.
45. Kinlay, S., G.G. Schwartz, A.G Olsson, et al. High-dose atorvastatin enhances the decline in inflammatory markers in patients with acute coronary syndromes in the MIRACL study [J]. Circulation,2003,108(13):1560-6.
46. Jialal, I., D. Stein, D. Balis, et al. Effect of hydroxymethyl glutaryl coenzyme a reductase inhibitor therapy on high sensitive C-reactive protein levels [J]. Circulation,2001,103(15): 1933-5.
47. Ridker, P.M., N. Rifai, and S.P. Lowenthal. Rapid reduction in C-reactive protein with cerivastatin among 785 patients with primary hypercholesterolemia [J]. Circulation,2001, 103(9):1191-3.
48. Kinlay, S., T. Timms, M. Clark, et al. Comparison of effect of intensive lipid lowering with atorvastatin to less intensive lowering with lovastatin on C-reactive protein in patients with stable angina pectoris and inducible myocardial ischemia [J]. Am J Cardiol,2002,89(10): 1205-7.
49. Ridker, P.M., N. Rifai, M.A. Pfeffer, et al. Inflammation, pravastatin, and the risk of coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events (CARE) Investigators [J]. Circulation,1998,98(9):839-44.
50. Moor, E., M. Blomback, A. Silveira, et al. Haemostatic function in patients undergoing coronary artery bypass grafting:peroperative perturbations and relations to saphenous vein graft closure [J]. Thromb Res,2000,98(1):39-49.
51. Danenberg, H.D., A.J. Szalai, R.V. Swaminathan, et al. Increased thrombosis after arterial injury in human C-reactive protein-transgenic mice [J]. Circulation,2003,108(5):512-5.
52. Vasan, R.S., L.M. Sullivan, R. Roubenoff, et al. Inflammatory markers and risk of heart failure in elderly subjects without prior myocardial infarction:the Framingham Heart Study [J]. Circulation,2003,107(11):1486-91.
53. Bursi, F., S.A. Weston, J.M. Killian, et al. C-reactive protein and heart failure after myocardial infarction in the community [J]. Am J Med,2007,120(7):616-22.
54. Griselli, M., J. Herbert, W.L. Hutchinson, et al. C-reactive protein and complement are important mediators of tissue damage in acute myocardial infarction [J]. J Exp Med,1999, 190(12):1733-40.
55. Nashef, S.A., F. Roques, P. Michel, et al. European system for cardiac operative risk evaluation (EuroSCORE) [J]. Eur J Cardiothorac Surg,1999,16(1):9-13.
56. van der Harst, P., A.A. Voors, M. Volbeda, et al. Usefulness of preoperative C-reactive protein and soluble intercellular adhesion molecule-1 level for predicting future cardiovascular events after coronary artery bypass grafting [J]. Am J Cardiol,2006,97(12):1697-701.
1. Castelli, W.P. Lipids, risk factors and ischaemic heart disease [J]. Atherosclerosis,1996,124 SupplS1-9.
2. Harker, L.A., R. Ross, S.J. Slichter, et al. Homocystine-induced arteriosclerosis. The role of endothelial cell injury and platelet response in its genesis [J]. J Clin Invest,1976,58(3): 731-41.
3. Lind, L. Circulating markers of inflammation and atherosclerosis [J]. Atherosclerosis,2003, 169(2):203-14.
4. Ross, R. Atherosclerosis--an inflammatory disease [J]. N Engl J Med,1999,340(2):115-26.
5. Drakopoulou, M., K. Toutouzas, E. Stefanadi, et al. Association of inflammatory markers with angiographic severity and extent of coronary artery disease [J]. Atherosclerosis,2009, 206(2):335-9.
6. Park, D.W., C.W. Lee, S.C. Yun, et al. Prognostic impact of preprocedural C reactive protein levels on 6-month angiographic and 1-year clinical outcomes after drug-eluting stent implantation [J]. Heart,2007,93(9):1087-92.
7. Hansson, G.K. Inflammation, atherosclerosis, and coronary artery disease [J]. N Engl J Med, 2005,352(16):1685-95.
8. Singh, S.K., M.V. Suresh, B. Voleti, et al. The connection between C-reactive protein and atherosclerosis [J]. Ann Med,2008,40(2):110-20.
9. Ridker, P.M. High-sensitivity C-reactive protein:potential adjunct for global risk assessment in the primary prevention of cardiovascular disease [J]. Circulation,2001,103(13):1813-8.
10. Pearson, T.A., G.A. Mensah, R.W. Alexander, et al. Markers of inflammation and cardiovascular disease:application to clinical and public health practice:A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association [J]. Circulation,2003,107(3):499-511.
11. Shrive, A.K., GM. Cheetham, D. Holden, et al. Three dimensional structure of human C-reactive protein [J]. Nat Struct Biol,1996,3(4):346-54.
12. Reynolds, G.D. and R.P. Vance. C-reactive protein immunohistochemical localization in normal and atherosclerotic human aortas [J]. Arch Pathol Lab Med,1987,111(3):265-9.
13. Torzewski, J., M. Torzewski, D.E. Bowyer, et al. C-reactive protein frequently colocalizes with the terminal complement complex in the intima of early atherosclerotic lesions of human coronary arteries [J]. Arterioscler Thromb Vasc Biol,1998,18(9):1386-92.
14. Maier, W., L.A. Altwegg, R. Corti, et al. Inflammatory markers at the site of ruptured plaque in acute myocardial infarction:locally increased interleukin-6 and serum amyloid A but decreased C-reactive protein [J]. Circulation,2005,111(11):1355-61.
15. Ferri, C., G. Croce, V. Cofini, et al. C-reactive protein:interaction with the vascular endothelium and possible role in human atherosclerosis [J]. Curr Pharm Des,2007,13(16): 1631-45.
16. Liuzzo, G, L.M. Biasucci, J.R. Gallimore, et al. The prognostic value of C-reactive protein and serum amyloid a protein in severe unstable angina [J]. N Engl J Med,1994,331(7): 417-24.
17. Ridker, P.M. Clinical application of C-reactive protein for cardiovascular disease detection and prevention [J]. Circulation,2003,107(3):363-9.
18. Kinjo, K., H. Sato, Y. Ohnishi, et al. Impact of high-sensitivity C-reactive protein on predicting long-term mortality of acute myocardial infarction [J]. Am J Cardiol,2003,91(8): 931-5.
19. Ridker, P.M., R.J. Glynn, and C.H. Hennekens. C-reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction [J]. Circulation, 1998,97(20):2007-11.
20. Ridker, P.M., C.H. Hennekens, J.E. Buring, et al. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women [J]. N Engl J Med,2000, 342(12):836-43.
21. Ablij, H. and A. Meinders. C-reactive protein:history and revival [J]. Eur J Intern Med,2002, 13(7):412.
22. Ballou, S.P. and G. Lozanski. Induction of inflammatory cytokine release from cultured human monocytes by C-reactive protein [J]. Cytokine,1992,4(5):361-8.
23. Zwaka, T.P., V. Hombach, and J. Torzewski. C-reactive protein-mediated low density lipoprotein uptake by macrophages:implications for atherosclerosis [J]. Circulation,2001, 103(9):1194-7.
24. Cermak, J., N.S. Key, R.R. Bach, et al. C-reactive protein induces human peripheral blood monocytes to synthesize tissue factor [J]. Blood,1993,82(2):513-20.
25. Moor, E., M. Blomback, A. Silveira, et al. Haemostatic function in patients undergoing coronary artery bypass grafting:peroperative perturbations and relations to saphenous vein graft closure [J]. Thromb Res,2000,98(1):39-49.
26. Danenberg, H.D., A.J. Szalai, R.V. Swaminathan, et al. Increased thrombosis after arterial injury in human C-reactive protein-transgenic mice [J]. Circulation,2003,108(5):512-5.
27. Williams, T.N., C.X. Zhang, B.A. Game, et al. C-reactive protein stimulates MMP-1 expression in U937 histiocytes through Fc[gamma]RII and extracellular signal-regulated kinase pathway::an implication of CRP involvement in plaque destabilization [J]. Arterioscler Thromb Vasc Biol,2004,24(1):61-6.
28. Montero, I., J. Orbe, N. Varo, et al. C-reactive protein induces matrix metalloproteinase-1 and-10 in human endothelial cells:implications for clinical and subclinical atherosclerosis [J]. J Am Coll Cardiol,2006,47(7):1369-78.
29. van Straten, A.H., M.A. Soliman Hamad, A.J. van Zundert, et al. Preoperative C-reactive protein levels to predict early and late mortalities after coronary artery bypass surgery:eight years of follow-up [J]. J Thorac Cardiovasc Surg,2009,138(4):954-8.
30. Kim, D.H., J.K. Shim, S.W. Hong, et al. Predictive value of C-reactive protein for major postoperative complications following off-pump coronary artery bypass surgery:prospective and observational trial [J]. Circ J,2009,73(5):872-7.
31. Balciunas, M., L. Bagdonaite, R. Samalavicius, et al. Pre-operative high sensitive C-reactive protein predicts cardiovascular events after coronary artery bypass grafting surgery:a prospective observational study [J]. Ann Card Anaesth,2009,12(2):127-32.
32. Cappabianca, G, D. Paparella, G. Visicchio, et al. Preoperative C-reactive protein predicts mid-term outcome after cardiac surgery [J]. Ann Thorac Surg,2006,82(6):2170-8.
33. Biancari, F., J. Lahtinen, S. Lepojarvi, et al. Preoperative C-reactive protein and outcome after coronary artery bypass surgery [J]. Ann Thorac Surg,2003,76(6):2007-12.
34. Steinberg, D. and A.M. Gotto, Jr. Preventing coronary artery disease by lowering cholesterol levels:fifty years from bench to bedside [J]. JAMA,1999,282(21):2043-50.
35. Halcox, J.P. and J.E. Deanfield. Beyond the laboratory:clinical implications for statin pleiotropy [J]. Circulation,2004,109(21 Suppl 1):II42-8.
36. Ridker, P.M., N. Rifai, M.A. Pfeffer, et al. Long-term effects of pravastatin on plasma concentration of C-reactive protein. The Cholesterol and Recurrent Events (CARE) Investigators [J]. Circulation,1999,100(3):230-5.
37. Kaul, P., Y. Fu, W.C. Chang, et al. Prognostic value of ST segment depression in acute coronary syndromes:insights from PARAGON-A applied to GUSTO-IIb. PARAGON-A and GUSTO IIb Investigators. Platelet IIb/IIIa Antagonism for the Reduction of Acute Global Organization Network [J]. J Am Coll Cardiol,2001,38(1):64-71.
38. Ortego, M., C. Bustos, M.A. Hernandez-Presa, et al. Atorvastatin reduces NF-kappaB activation and chemokine expression in vascular smooth muscle cells and mononuclear cells [J]. Atherosclerosis,1999,147(2):253-61.
39. Bustos, C., M.A. Hernandez-Presa, M. Ortego, et al. HMG-CoA reductase inhibition by atorvastatin reduces neointimal inflammation in a rabbit model of atherosclerosis [J]. J Am Coll Cardiol,1998,32(7):2057-64.
40. Rezaie-Majd, A., G.W. Prager, R.A. Bucek, et al. Simvastatin reduces the expression of adhesion molecules in circulating monocytes from hypercholesterolemic patients [J]. Arterioscler Thromb Vasc Biol,2003,23(3):397-403.
41. Bonetti, P.O., L.O. Lerman, C. Napoli, et al. Statin effects beyond lipid lowering--are they clinically relevant? [J]. Eur Heart J,2003,24(3):225-48.
42. Ikeda, U., M. Shimpo, R. Ohki, et al. Fluvastatin inhibits matrix metalloproteinase-1 expression in human vascular endothelial cells [J]. Hypertension,2000,36(3):325-9.
43. Ikeda, U. and K. Shimada. Statins and monocytes [J]. Lancet,1999,353(9169):2070.
44. Crisby, M., G. Nordin-Fredriksson, P.K.. Shah, et al. Pravastatin treatment increases collagen content and decreases lipid content, inflammation, metalloproteinases, and cell death in human carotid plaques:implications for plaque stabilization [J]. Circulation,2001,103(7): 926-33.
45. Fukumoto, Y, P. Libby, E. Rabkin, et al. Statins alter smooth muscle cell accumulation and collagen content in established atheroma of watanabe heritable hyperlipidemic rabbits [J]. Circulation,2001,103(7):993-9.
46. Neuhaus, O., S. Strasser-Fuchs, F. Fazekas, et al. Statins as immunomodulators:comparison with interferon-beta 1b in MS [J]. Neurology,2002,59(7):990-7.
47. Bourcier, T. and P. Libby. HMG CoA reductase inhibitors reduce plasminogen activator inhibitor-1 expression by human vascular smooth muscle and endothelial cells [J]. Arterioscler Thromb Vasc Biol,2000,20(2):556-62.
48. Aikawa, M., E. Rabkin, S. Sugiyama, et al. An HMG-CoA reductase inhibitor, cerivastatin, suppresses growth of macrophages expressing matrix metalloproteinases and tissue factor in vivo and in vitro [J]. Circulation,2001,103(2):276-83.
49. Eto, M., T. Kozai, F. Cosentino, et al. Statin prevents tissue factor expression in human endothelial cells:role of Rho/Rho-kinase and Akt pathways [J]. Circulation,2002,105(15): 1756-9.
50. Undas, A., K.E. Brummel, J. Musial, et al. Simvastatin depresses blood clotting by inhibiting activation of prothrombin, factor Ⅴ, and factor ⅩⅢ and by enhancing factor Va inactivation [J]. Circulation,2001,103(18):2248-53.
51. Strandberg, T.E., H. Vanhanen, and M.J. Tikkanen. Effect of statins on C-reactive protein in patients with coronary artery disease [J]. Lancet,1999,353(9147):118-9.
52. Chan, A.W., D.L. Bhatt, D.P. Chew, et al. Relation of inflammation and benefit of statins after percutaneous coronary interventions [J]. Circulation,2003,107(13):1750-6.
53. Morrow, D.A., J.A. de Lemos, M.S. Sabatine, et al. Clinical relevance of C-reactive protein during follow-up of patients with acute coronary syndromes in the Aggrastat-to-Zocor Trial [J]. Circulation,2006,114(4):281-8.
54. Albert, M.A., E. Danielson, N. Rifai, et al. Effect of statin therapy on C-reactive protein levels:the pravastatin inflammation/CRP evaluation (PRINCE):a randomized trial and cohort study [J]. JAMA,2001,286(1):64-70.
55. Kinlay, S., G.G. Schwartz, A.G. Olsson, et al. High-dose atorvastatin enhances the decline in inflammatory markers in patients with acute coronary syndromes in the MIRACL study [J]. Circulation,2003,108(13):1560-6.
56. Jialal, I., D. Stein, D. Balis, et al. Effect of hydroxymethyl glutaryl coenzyme a reductase inhibitor therapy on high sensitive C-reactive protein levels [J]. Circulation,2001,103(15): 1933-5.
57. Ridker, P.M., N. Rifai, and S.P. Lowenthal. Rapid reduction in C-reactive protein with cerivastatin among 785 patients with primary hypercholesterolemia [J]. Circulation,2001, 103(9):1191-3.
58. Kinlay, S., T. Timms, M. Clark, et al. Comparison of effect of intensive lipid lowering with atorvastatin to less intensive lowering with lovastatin on C-reactive protein in patients with stable angina pectoris and inducible myocardial ischemia [J]. Am J Cardiol,2002,89(10): 1205-7.
59. Ridker, P.M., E. Danielson, F.A. Fonseca, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein [J]. N Engl J Med,2008,359(21): 2195-207.
60. The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts. The Post Coronary Artery Bypass Graft Trial Investigators [J]. N Engl J Med,1997,336(3): 153-62.
61. Knatterud, GL., Y. Rosenberg, L. Campeau, et al. Long-term effects on clinical outcomes of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation in the post coronary artery bypass graft trial. Post CABG Investigators [J]. Circulation,2000,102(2):157-65.
62. Flaker, G.C., J.W. Warnica, F.M. Sacks, et al. Pravastatin prevents clinical events in revascularized patients with average cholesterol concentrations. Cholesterol and Recurrent Events CARE Investigators [J]. J Am Coll Cardiol,1999,34(1):106-12.
63. Shepherd, J., J.J. Kastelein, V. Bittner, et al. Intensive lipid lowering with atorvastatin in patients with coronary heart disease and chronic kidney disease:the TNT (Treating to New Targets) study [J]. J Am Coll Cardiol,2008,51(15):1448-54.
64. Ridker, P.M., N. Rifai, M. Clearfield, et al. Measurement of C-reactive protein for the targeting of statin therapy in the primary prevention of acute coronary events [J]. N Engl J Med,2001,344(26):1959-65.
65. Gaudino, M., G Nasso, F. Andreotti, et al. Preoperative C-reactive protein level and outcome following coronary surgery [J]. Eur J Cardiothorac Surg,2002,22(4):521-6.