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Effects of statin therapy according to plasma high-sensitivity C-reactive protein concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA): a retrospective analysis
- Source :
- Circulation, Vol. 120, No 22 (2009) pp. 2188-2196
- Publication Year :
- 2009
-
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) P =0.024). In the low hs-CRP group, 175 placebo-treated (8.9 per 100 patient-years of follow-up) and 188 rosuvastatin-treated (9.8 per 100 patient-years of follow-up) patients experienced this outcome (hazard ratio, 1.09; 95% confidence interval, 0.89 to 1.34; P >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.
- Subjects :
- Male
Kaplan-Meier Estimate
Gastroenterology
Risk Factors
Heart Failure, Systolic/blood/drug therapy/mortality
Multicenter Studies as Topic
Myocardial infarction
Rosuvastatin Calcium
Randomized Controlled Trials as Topic
ddc:616
Aged, 80 and over
Cholesterol, HDL/blood
Sulfonamides
biology
Hazard ratio
C-Reactive Protein/*metabolism
Hospitalization
Triglycerides/blood
C-Reactive Protein
Cholesterol, LDL/blood
Female
Cardiology and Cardiovascular Medicine
Pyrimidines/*therapeutic use
medicine.drug
medicine.medical_specialty
Placebo
Sulfonamides/*therapeutic use
Fluorobenzenes/*therapeutic use
Physiology (medical)
Internal medicine
medicine
Humans
Rosuvastatin
Triglycerides
Hospitalization/statistics & numerical data
Aged
Retrospective Studies
business.industry
C-reactive protein
Cholesterol, HDL
nutritional and metabolic diseases
Cholesterol, LDL
medicine.disease
Confidence interval
Fluorobenzenes
Endocrinology
Pyrimidines
Heart failure
biology.protein
Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Heart Failure, Systolic
Subjects
Details
- ISSN :
- 15244539 and 00097322
- Volume :
- 120
- Issue :
- 22
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi.dedup.....e1bce3558c7a8b627503387160039ac2