Title

Long term effects of pravastatin on plasma concentration of C reactive protein

Purpose

To determine whether long term therapy with pravastatin reduces the levels of the inflammatory marker, C-reactive protein.

Design

As per CARE

Patients

472 randomly selected participants in CARE in whom C-reactive protein was measured at baseline and at 5 years
and who had remained free of recurrent vascular events during follow-up.

Follow-up

5 years

Treatment regimen

As per CARE

Results

• While C-reactive protein levels increased over time in placebo patients (median change = +4.2%; p=0.2 and mean change =+0.07 g/dL; p=0.04), they decreased in pravastatin patients (median change =17.4%; p=0.004 and mean change =-0.07 mg/dL; p=0.002). Median, mean, and absolute change in C-reactive protein were significantly lower in the pravastatin group at 5 years (-21.6%; p=0.007; -37.8%, p=0.002; and 0.137 g/dL; p=0.003, respectively).
• The changes in C-reactive protein over time did not correlate with change in LDL cholesterol among pravastatin or placebo treated patients.
• There was also a lack of a correlation between change in C-reactive protein and changes in total cholesterol or HDL levels.
• Pravastatin reduced C-reactive protein levels at all LDL change increments.

Conclusions

In post myocardial infarction patients, C-reactive protein levels tended to increase over 5 years in patients receiving standard therapy plus placebo; pravastatin decreased C-reactive protein levels independent of the degree of lipid improvement.