Effects of Statin Therapy According to Plasma High-Sensitivity C-Reactive Protein Concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)
- 1 December 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 120 (22), 2188-2196
- https://doi.org/10.1161/CIRCULATIONAHA.109.849117
Abstract
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) 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). Conclusion— 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 ≥2.0 mg/L. Clinical Trial Registration Information— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00206310.This publication has 23 references indexed in Scilit:
- Inflammation and long-term mortality in acute congestive heart failureAmerican Heart Journal, 2006
- Anti-Inflammatory Effects of Statins: Clinical Evidence and Basic MechanismsNature Reviews Drug Discovery, 2005
- Toward Immunomodulatory and Anti-Inflammatory Properties of StatinsTrends in Cardiovascular Medicine, 2005
- Statins Reduce Interleukin-6–Induced C-Reactive Protein in Human HepatocytesArteriosclerosis, Thrombosis, and Vascular Biology, 2005
- Inflammatory and anti‐inflammatory cytokines in chronic heart failure: Potential therapeutic implicationsAnnals of Medicine, 2005
- C-Reactive Protein Levels and Outcomes after Statin TherapyThe New England Journal of Medicine, 2005
- Measurement of C-Reactive Protein for the Targeting of Statin Therapy in the Primary Prevention of Acute Coronary EventsThe New England Journal of Medicine, 2001
- The role of tumor necrosis factor in the pathophysiology of heart failureJournal of the American College of Cardiology, 2000
- Increased concentrations of tumour necrosis factor in "cachectic" patients with severe chronic heart failure.Heart, 1991
- Elevated Circulating Levels of Tumor Necrosis Factor in Severe Chronic Heart FailureThe New England Journal of Medicine, 1990