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Life Sci. 2013 Sep 3;93(8):338-43. doi: 10.1016/j.lfs.2013.07.008. Epub 2013 Jul 19.

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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  • 1Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Italy. mpirro@unipg.it

Abstract

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 (β=0.17, p=0.01) and HDL cholesterol levels (β=-0.27, p<0.001) were correlates of CIMT, irrespective of confounders. High CRP levels (>3mg/L) were associated with a 2.7-fold increased risk of having high CIMT (>1.25mm). 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 (β=0.28, p=0.004) and HDL cholesterol (β=-0.21, p=0.03) were associated with CIMT. In the combined therapy group, HDL cholesterol was the only significant CIMT correlate (β=-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.

© 2013.

KEYWORDS:

Atherosclerosis; C-reactive protein; Carotid; Hypercholesterolemia; Intima-media thickness; Statin

PMID:
23871987
[PubMed - indexed for MEDLINE]
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