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  • Title: On-treatment C-reactive protein and HDL cholesterol levels in patients at intermediate cardiovascular risk: impact on carotid intima-media thickness.
    Author: Pirro M, Vaudo G, Lupattelli G, Pasqualini L, Mannarino MR, Schillaci G, Alaeddin A, Paciullo F, Fallarino F, Bagaglia F, Mannarino E.
    Journal: Life Sci; 2013 Sep 03; 93(8):338-43. PubMed ID: 23871987.
    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.
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