Effect of hydroxymethyl glutaryl coenzyme A reductase inhibitor therapy onhigh sensitive C-reactive protein levels

Background-Prospective studies indicate that baseline levels of C-reactive protein (CRP), the prototypic marker of inflammation, are associated with a n increased risk for cardiovascular events. Limited studies have examined t herapies that influence high-sensitive CRP (hs-CRP) levels, especially in h yperlipidemic patients. Thus, we tested the effects of 3 hydroxymethyl glut aryl coenzyme A reductase inhibitors (statins), simvastatin (20 mg/d), prav astatin (40 mg/d), and atorvastatin (10 mg/d), on levels of hs-CRP in a ran domized, double-blind, crossover trial of 22 patients with combined hyperli pidemia (LDL cholesterol >130 mg/dL and triglycerides of 200 to 600 mg/dL). Methods and Results-After 6 weeks of an American Heart Association Step 1 d iet, fasting blood samples were drawn at baseline and after 6 weeks of ther apy with each drug. hs-CRP levels were significantly decreased after treatm ent with all 3 statins compared with baseline (median values: baseline, 2.6 mg/L; atorvastatin, 1.7 mg/L; simvastatin, 1.7 mg/L; and pravastatin, 1.9 mg/L; P<0.025). The reductions obtained with the 3 statins were similar. In addition, there was no significant effect on either plasma interleukin-6 o r interleukin-6 soluble receptor levels. There was no relationship between reductions in hs-CRP and LDL cholesterol. Conclusions-Pravastatin, simvastatin, and atorvastatin significantly decrea sed levels of hs-CRP. These data support an anti-inflammatory effect of the se drugs.