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Effects of statin t...
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.
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McMurray, John J V (författare)
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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, 1937 (författare)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory
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Wedel, Hans (författare)
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Lindberg, Magnus (författare)
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- Waagstein, Finn, 1938 (författare)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory
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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, 1938 (författare)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory
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(creator_code:org_t)
- 2009
- 2009
- Engelska.
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Ingår i: Circulation. - 1524-4539. ; 120:22, s. 2188-96
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- 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.
Nyckelord
- 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
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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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...
-
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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- Artiklar i publikationen
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Circulation
- Av lärosätet
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Göteborgs universitet