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Effects of statin t...
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McMurray, John J V
(författare)
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.
- Artikel/kapitelEngelska2009
Förlag, utgivningsår, omfång ...
Nummerbeteckningar
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LIBRIS-ID:oai:gup.ub.gu.se/113145
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https://gup.ub.gu.se/publication/113145URI
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https://doi.org/10.1161/CIRCULATIONAHA.109.849117DOI
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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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.
Ämnesord och genrebeteckningar
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Aged
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Aged
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80 and over
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C-Reactive Protein
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metabolism
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Cholesterol
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HDL
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blood
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Cholesterol
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LDL
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blood
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Female
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Fluorobenzenes
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therapeutic use
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Heart Failure
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Systolic
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blood
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drug therapy
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mortality
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Hospitalization
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statistics & numerical data
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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therapeutic use
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Kaplan-Meiers Estimate
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Male
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Multicenter Studies as Topic
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Pyrimidines
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therapeutic use
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Randomized Controlled Trials as Topic
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Retrospective Studies
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Risk Factors
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Sulfonamides
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therapeutic use
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Triglycerides
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blood
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Kjekshus, John
(författare)
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Gullestad, Lars
(författare)
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Dunselman, Peter
(författare)
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Hjalmarson, Åke,1937Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory(Swepub:gu)xhjala
(författare)
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Wedel, Hans
(författare)
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Lindberg, Magnus
(författare)
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Waagstein, Finn,1938Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory(Swepub:gu)xwaafi
(författare)
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Grande, Peer
(författare)
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Hradec, Jaromir
(författare)
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Kamenský, Gabriel
(författare)
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Korewicki, Jerzy
(författare)
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Kuusi, Timo
(författare)
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Mach, François
(författare)
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Ranjith, Naresh
(författare)
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Wikstrand, John,1938Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory(Swepub:gu)xwikjo
(författare)
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Göteborgs universitetWallenberglaboratoriet
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Circulation120:22, s. 2188-961524-4539
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Till lärosätets databas
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McMurray, John J ...
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Kjekshus, John
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Gullestad, Lars
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Dunselman, Peter
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Hjalmarson, Åke, ...
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Wedel, Hans
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visa fler...
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Lindberg, Magnus
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Waagstein, Finn, ...
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Grande, Peer
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Hradec, Jaromir
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Kamenský, Gabrie ...
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Korewicki, Jerzy
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Kuusi, Timo
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Mach, François
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Ranjith, Naresh
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Wikstrand, John, ...
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visa färre...
- Artiklar i publikationen
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Circulation
- Av lärosätet
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Göteborgs universitet