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The association of albuminuria and high-sensitivity C-reactive protein with the efficacy of HMG-coenzyme A reductase inhibitors for cardiovascular event prevention

Ozyilmaz, A., Boersma, C., Visser, S. T., Postma, M. J., de Jong-van den Berg, L. T. W., Lambers-Heerspink, H. J., de Jong, P. E. & Gansevoort, R. T., May-2016, In : European Journal of Preventive Cardiology. 23, 8, p. 847-855 9 p.

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DOI

Background: It is not clear which hypercholesterolemic patients benefit most from beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitors with respect to the prevention of cardiovascular events. Early signs of atherosclerotic vascular damage may identify high-risk patients.

Design: We studied whether subjects with hypercholesterolemia will benefit more from starting statin treatment in the case of high albuminuria and/or high-sensitivity C-reactive protein (hsCRP).

Methods: Included were subjects who had hypercholesterolemia at baseline, a negative cardiovascular disease history and who were not treated with statins. In total, 2011 subjects were analysed, of whom 695 started with a statin during a follow-up of 7.0 +/- 1.7 years. Adjusted hazard ratios (HRs) for cardiovascular events were calculated in subjects who started versus those who did not start a statin stratified for albuminuria less than or >= 15mg/day and/or hsCRP less than or >= 3mg/L.

Results: The start of a statin was associated with a beneficial effect on cardiovascular risk in subjects with high albuminuria (HR 0.38 (0.23-0.60)), while the effect of starting a statin was non-significant in subjects with low albuminuria (HR 0.74 (0.44-1.24), P for interaction

Conclusions: The start of statin treatment is associated with a significantly lower absolute as well as relative risk of cardiovascular events in subjects with hypercholesterolemia and elevated albuminuria, whereas these drugs had less effect in subjects with normal albuminuria.

Original languageEnglish
Pages (from-to)847-855
Number of pages9
JournalEuropean Journal of Preventive Cardiology
Volume23
Issue number8
Early online date10-Sep-2015
Publication statusPublished - May-2016

    Keywords

  • Albuminuria, high-sensitivity C-reactive protein, HMG-CoA reductase inhibitor, cardiovascular event, KIDNEY-DISEASE MEASURES, STAGE RENAL-DISEASE, RISK, METAANALYSIS, INFLAMMATION, INDIVIDUALS, MORTALITY, MICROALBUMINURIA, HYPERTENSION, PRAVASTATIN

ID: 23822353