Comparison of Effects of High (80 mg) Versus Low (20 mg) Dose of Simvastatin on C-Reactive Protein and Lipoproteins in Patients With Angiographic Evidence of Coronary Arterial Narrowing

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Abstract

Although previous studies have demonstrated that various "statins" decrease levels of high-sensitivity C-reactive protein (hs-CRP), the dose-response relation for lowering hs-CRP by the clinically important drug simvastatin compared with lipid lowering is unclear. A 16-week, randomized, double-blind study was performed in patients with stable coronary artery disease and high hs-CRP levels (>3 mg/L). Subjects were randomized to placebo, 20 mg of simvastatin, or 80 mg of simvastatin for 12 weeks. Those currently on a statin first underwent a 4-week washout. Of the 107 total patients randomized, 96 completed the trial, and 89 were able to be evaluated for efficacy. Changes in hs-CRP differed across simvastatin and placebo groups (change score +1.6 vs -0.6 mg/L, p = 0.004), but no dose response was observed when comparing 80 with 20 mg/day (-0.6 vs -0.5 mg/L, respectively). A strong dose response was observed for changes in total (p <0.01) and low-density lipoprotein (p <0.001) cholesterol. hs-CRP changes did not correlate with low-density lipoprotein changes. In conclusion, this randomized trial in patients with chronic stable coronary artery disease showed a strong dose response for simvastatin for total and low-density lipoprotein cholesterol lowering but not for hs-CRP. © 2007 Elsevier Inc. All rights reserved.

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Meredith, K. G., Horne, B. D., Pearson, R. R., Maycock, C. A., Lappe, D. L., Anderson, J. L., & Muhlestein, J. B. (2007). Comparison of Effects of High (80 mg) Versus Low (20 mg) Dose of Simvastatin on C-Reactive Protein and Lipoproteins in Patients With Angiographic Evidence of Coronary Arterial Narrowing. American Journal of Cardiology, 99(2), 149–153. https://doi.org/10.1016/j.amjcard.2006.07.079

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