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

• Published in: The American journal of cardiology 2007-01, Vol.99 (2), p.149-153
• Main Authors: Meredith, Kent G., MD, Horne, Benjamin D., PhD, MPH, Pearson, Robert R., BS, Maycock, Chloe Allen, MD, Lappe, Donald L., MD, Anderson, Jeffrey L., MD, Muhlestein, Joseph B., MD
• Format: Article
• Language: English
• Subjects: Aged; Biochemistry; Biological and medical sciences; Biomarkers - blood; C-Reactive Protein - drug effects; C-Reactive Protein - metabolism; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular system; Coronary Angiography; Coronary Stenosis - blood; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - drug therapy; Dose-Response Relationship, Drug; Double-Blind Method; Female; Follow-Up Studies; Heart; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Investigative techniques, diagnostic techniques (general aspects); Lipoproteins - blood; Lipoproteins - drug effects; Male; Medical sciences; Prospective Studies; Proteins; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Simvastatin - administration & dosage; Simvastatin - therapeutic use; Statins; Treatment Outcome
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2006.07.079

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