Statin therapy, inflammation and recurrent coronary events in patients following coronary stent implantation

OBJECTIVES We sought to investigate whether statin therapy affects the asso ciation between preprocedural C-reactive protein (CRP) levels and the risk for recurrent coronary events in patients undergoing coronary stent implant ation. BACKGROUND Low-grade inflammation as detected by elevated CRP levels predic ts the risk of recurrent coronary events. The effect of inflammation on cor onary risk may be attenuated by statin therapy. METHODS We investigated a potential interrelation among statin therapy, ser um evidence of inflammation, and the risk for recurrent coronary events in 388 consecutive patients undergoing coronary stent implantation. Patients w ere grouped according to the median CRP level (0.6 mg/dl) and to the presen ce of statin therapy. RESULTS A primary combined end point event occurred significantly more freq uently in patients with elevated CRP levels without statin therapy (RR [rel ative risk] 2.37, 95% Cl [confidence interval] [1.3 to 4.2]). Importantly, in the presence of statin therapy, the RR for recurrent events was signific antly reduced in the patients,vith elevated CRP levels (RR 1.27 [0.7 to 2.1 ]) to about the same degree as in patients with CRP levels below 0.6 mg/dl and who did not receive statin therapy (RR 1.1 [0.8 to 1.3]). CONCLUSIONS Statin therapy significantly attenuates the increased risk for major adverse cardiac events in patients with elevated CRP levels undergoin g coronary stent implantation, suggesting that statin therapy interferes wi th the detrimental effects of inflammation on accelerated atherosclerotic d isease progression following coronary stenting. (J Am Coll Cardiol 2001;38: 2006-12) (C) 2001 by the American College of Cardiology.