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  • McMurray, John J V (author)

Effects of statin therapy according to plasma high-sensitivity C-reactive protein concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA): a retrospective analysis.

  • Article/chapterEnglish2009

Publisher, publication year, extent ...

  • 2009

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/113145
  • https://gup.ub.gu.se/publication/113145URI
  • https://doi.org/10.1161/CIRCULATIONAHA.109.849117DOI

Supplementary language notes

  • Language:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • BACKGROUND: We examined whether the antiinflammatory action of statins may be of benefit in heart failure, a state characterized by inflammation in which low cholesterol is associated with worse outcomes. METHODS AND RESULTS: We compared 10 mg rosuvastatin daily with placebo in patients with ischemic systolic heart failure according to baseline high sensitivity-C reactive protein (hs-CRP) <2.0 mg/L (placebo, n=779; rosuvastatin, n=777) or > or = 2.0 mg/L (placebo, n=1694; rosuvastatin, n=1711). The primary outcome was cardiovascular death, myocardial infarction, or stroke. Baseline low-density lipoprotein was the same, and rosuvastatin reduced low-density lipoprotein by 47% in both hs-CRP groups. Median hs-CRP was 1.10 mg/L in the lower and 5.60 mg/L in the higher hs-CRP group, with higher hs-CRP associated with worse outcomes. The change in hs-CRP with rosuvastatin from baseline to 3 months was -6% in the low hs-CRP group (27% with placebo) and -33.3% in the high hs-CRP group (-11.1% with placebo). In the high hs-CRP group, 548 placebo-treated (14.0 per 100 patient-years of follow-up) and 498 rosuvastatin-treated (12.2 per 100 patient-years of follow-up) patients had a primary end point (hazard ratio of placebo to rosuvastatin, 0.87; 95% confidence interval, 0.77 to 0.98; P=0.024). In the low hs-CRP group, 175 placebo-treated (8.9 per 100 patient-years of follow-up) and 188 rosuvastatin-treated (9.8 per 100 patient-years of follow-up) patients experienced this outcome (hazard ratio, 1.09; 95% confidence interval, 0.89 to 1.34; P>0.2; P for interaction=0.062). The numbers of deaths were as follows: 581 placebo-treated (14.1 per 100 patient-years of follow-up) and 532 rosuvastatin-treated (12.6 per 100 patient-years) patients in the high hs-CRP group (hazard ratio, 0.89; 95% confidence interval, 0.79 to 1.00; P=0.050) and 170 placebo-treated (8.3 per 100 patient-years) and 192 rosuvastatin-treated (9.7 per 100 patient-years) patients in the low hs-CRP group (hazard ratio, 1.17; 95% confidence interval, 0.95 to 1.43; P=0.14; P for interaction=0.026). CONCLUSIONS: In this retrospective hypothesis-generating study, we found a significant interaction between hs-CRP and the effect of rosuvastatin for most end points whereby rosuvastatin treatment was associated with better outcomes in patients with hs-CRP > or = 2.0 mg/L. CLINICAL TRIAL REGISTRATION INFORMATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00206310.

Subject headings and genre

  • Aged
  • Aged
  • 80 and over
  • C-Reactive Protein
  • metabolism
  • Cholesterol
  • HDL
  • blood
  • Cholesterol
  • LDL
  • blood
  • Female
  • Fluorobenzenes
  • therapeutic use
  • Heart Failure
  • Systolic
  • blood
  • drug therapy
  • mortality
  • Hospitalization
  • statistics & numerical data
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • therapeutic use
  • Kaplan-Meiers Estimate
  • Male
  • Multicenter Studies as Topic
  • Pyrimidines
  • therapeutic use
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Risk Factors
  • Sulfonamides
  • therapeutic use
  • Triglycerides
  • blood

Added entries (persons, corporate bodies, meetings, titles ...)

  • Kjekshus, John (author)
  • Gullestad, Lars (author)
  • Dunselman, Peter (author)
  • Hjalmarson, Åke,1937Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory(Swepub:gu)xhjala (author)
  • Wedel, Hans (author)
  • Lindberg, Magnus (author)
  • Waagstein, Finn,1938Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory(Swepub:gu)xwaafi (author)
  • Grande, Peer (author)
  • Hradec, Jaromir (author)
  • Kamenský, Gabriel (author)
  • Korewicki, Jerzy (author)
  • Kuusi, Timo (author)
  • Mach, François (author)
  • Ranjith, Naresh (author)
  • Wikstrand, John,1938Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory(Swepub:gu)xwikjo (author)
  • Göteborgs universitetWallenberglaboratoriet (creator_code:org_t)

Related titles

  • In:Circulation120:22, s. 2188-961524-4539

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