C-reactive protein in patients with familial hypercholesterolemia: no effect of simvastatin therapy

Patients with familial hypercholesterolemia (FH) are especially at risk for premature cardiovascular disease (CVD). Recent studies revealed C-reactive protein (CRP) as a strong predictor of future first or recurrent CVD event s, suggesting that CRP plays an important role in the development of athero sclerosis. The aim of this study was to evaluate the effect of one year of simvastatin treatment on serum levels of CRP and to assess the influence of risk factors for CVD on CRP concentrations in patients with FH. We measure d baseline CRP levels in 337 patients with FH. A second blood sample, colle cted after one year of treatment with simvastatin (20-40 mg once daily) was measured in a subgroup of 129 patients. Patients with CVD present at basel ine had significantly higher serum levels of CRP (2.26 mg/l versus 1.55 mg/ l, P < 0.001). CRP levels were associated with smoking, body mass index, ag e, levels of triglycerides (TG), and the use of NSAIDs or anticoagulation d rugs. Simvastatin therapy significantly improved lipid profiles in the inte rvention group. There was a small, but non-significant decrease of CRP leve ls upon treatment. CRP decreased from 1.51 mg/l median (interquartile range (IQR) 0.76-3.41) at baseline to 1.24 mg/l median (IQR 0.72-2.92) after tre atment, (P = 0.328). In conclusion, CRP levels were associated with the pre sence of CVD in FH patients. Simvastatin therapy had no significant effect on CRP levels in these patients. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.