 |
 |
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
21 October 2003 | Volume 139 Issue 8 | Pages 670-682
Background: Statins reduce cardiovascular events to a greater extent than can be explained by their effect on lipids. Several studies have attempted to elucidate mechanisms by which statins reduce cardiovascular risk.
Purpose: To summarize the effects of statins on nonlipid serum markers and to correlate statins' effect on serum markers with lipid levels and cardiovascular outcomes.
Data Sources: MEDLINE (1980 to 2003) search limited to English-language articles.
Study Selection: Studies reporting original data in at least 10 participants on the effect of statins on outcomes of interest, excluding studies of cerivastatin, drug combinations, and patients with organ transplants.
Data Extraction: Study design, sample size, treatment, and outcome data extracted on the basis of preestablished criteria. When appropriate, meta-analysis was performed by using a random-effects model.
Data Synthesis: All statins are effective at lowering C-reactive protein levels, and the effect is not dose-dependent. Studies do not demonstrate a correlation between statins' effects on C-reactive protein levels and on lipids or cardiovascular outcomes. Statins do not affect fibrinogen levels, and limited data suggest little effect on lipid oxidation, tissue plasminogen activator, or plasminogen activator inhibitor. Platelet aggregation data are inconclusive.
Conclusions: Among nonlipid serum markers examined, only C-reactive protein levels are statistically significantly affected by statins. These findings suggest that statin-mediated anti-inflammatory effects may contribute to the ability of statins to reduce risk for cardiovascular disease. Overall, however, available data are insufficient to support recommendations for using nonlipid serum markers in decisions regarding statin therapy for individual patients.
Author and Article Information
From Tufts University School of Medicine and Tufts-New England Medical Center, Boston, Massachusetts.
Grant Support: By RxIntelligence (http://www.rxintelligence.com), a nonprofit organization dedicated to providing independent, objective information comparing the costs and effectiveness of pharmaceuticals.
Potential Financial Conflicts of Interest:Consultancies: R.H. Karas (Merck & Co., Pfizer); Honoraria: R.H. Karas (Merck & Co., Pfizer); Stock ownership or options (other than mutual funds): J. Lau (Merck & Co., Pfizer); Grants received: R.H. Karas (Merck & Co.).
Corresponding Author: Joseph Lau, MD, Tufts-New England Medical Center, Box 63, 750 Washington Street, Boston, MA 02111.
Current Author Addresses: Drs. Lau and Balk, Mr. Jordan, and Mr. Kupelnick: Tufts-New England Medical Center, Box 63, 750 Washington Street, Boston, MA 02111.
Dr. Karas: Tufts-New England Medical Center, Box 80, 750 Washington Street, Boston, MA 02111.
Dr. Goudas: Tufts-New England Medical Center, Box 298, 750 Washington Street, Boston, MA 02111.
Ms. Kim: Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111. REVIEW
Effects of Statins on Nonlipid Serum Markers Associated with Cardiovascular Disease
A Systematic Review
This article has been cited by other articles:
|
|
 |
|
  S. S. Daskalopoulou, J. A.C. Delaney, K. B. Filion, J. M. Brophy, N. E. Mayo, and S. Suissa Discontinuation of statin therapy following an acute myocardial infarction: a population-based study Eur. Heart J., September 1, 2008; 29(17): 2083 - 2091. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Z. LaCroix, S. L. Gray, A. Aragaki, B. B. Cochrane, A. B. Newman, C. L. Kooperberg, H. Black, J. D. Curb, P. Greenland, and N. F. Woods Statin Use and Incident Frailty in Women Aged 65 Years or Older: Prospective Findings From the Women's Health Initiative Observational Study J. Gerontol. A Biol. Sci. Med. Sci., April 1, 2008; 63(4): 369 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. RIFKIN and M. SARNAK Q: Should all patients with chronic kidney disease take a statin? Cleveland Clinic Journal of Medicine, February 1, 2008; 75(2): 118 - 120. [Full Text] [PDF]
|
|
|
|
 |
|
 S-S. Lee, S. Singh, L. Magder, and M. Petri Predictors of high sensitivity C-reactive protein levels in patients with systemic lupus erythematosus Lupus, February 1, 2008; 17(2): 114 - 123. [Abstract] [PDF]
|
|
|
|
 |
|
 P. M. Ridker C-Reactive Protein and the Prediction of Cardiovascular Events Among Those at Intermediate Risk: Moving an Inflammatory Hypothesis Toward Consensus J. Am. Coll. Cardiol., May 29, 2007; 49(21): 2129 - 2138. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kinlay Low-Density Lipoprotein-Dependent and -Independent Effects of Cholesterol-Lowering Therapies on C-Reactive Protein: A Meta-Analysis J. Am. Coll. Cardiol., May 22, 2007; 49(20): 2003 - 2009. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Which statin, what dose? DTB, May 1, 2007; 45(5): 33 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Atthobari, A. H. Brantsma, R. T. Gansevoort, S. T. Visser, F. W. Asselbergs, W. H. van Gilst, P. E. de Jong, L. T. W. de Jong-van den Berg, and on behalf of PREVEND study group The effect of statins on urinary albumin excretion and glomerular filtration rate: results from both a randomized clinical trial and an observational cohort study Nephrol. Dial. Transplant., November 1, 2006; 21(11): 3106 - 3114. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Sosa, E. M. Balk, J. Lau, O. Liangos, V. S. Balakrishnan, N. E. Madias, B. J. G. Pereira, and B. L. Jaber A systematic review of the effect of the Excebrane dialyser on biomarkers of lipid peroxidation Nephrol. Dial. Transplant., October 1, 2006; 21(10): 2825 - 2833. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P Casas, T. Shah, J. Cooper, E. Hawe, A. D McMahon, D. Gaffney, C. J Packard, D. S O'Reilly, I. Juhan-Vague, J. S Yudkin, et al. Insight into the nature of the CRP-coronary event association using Mendelian randomization Int. J. Epidemiol., August 1, 2006; 35(4): 922 - 931. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Morrow, J. A. de Lemos, M. S. Sabatine, S. D. Wiviott, M. A. Blazing, A. Shui, N. Rifai, R. M. Califf, and E. Braunwald Clinical Relevance of C-Reactive Protein During Follow-Up of Patients With Acute Coronary Syndromes in the Aggrastat-to-Zocor Trial Circulation, July 25, 2006; 114(4): 281 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. M. Scirica, D. A. Morrow, S. Verma, S. Devaraj, I. Jialal, B. M. Scirica, D. A. Morrow, S. Verma, S. Devaraj, and I. Jialal The Verdict Is Still Out Circulation, May 2, 2006; 113(17): 2128 - 2151. [Full Text] [PDF]
|
|
|
|
 |
|
 G. D. Smith Randomised by (your) god: robust inference from an observational study design J Epidemiol Community Health, May 1, 2006; 60(5): 382 - 388. [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Go, C. Iribarren, M. Chandra, P. V. Lathon, S. P. Fortmann, T. Quertermous, M. A. Hlatky, and for the Atherosclerotic Disease, Vascular Function Statin and beta-blocker therapy and the initial presentation of coronary heart disease. Ann Intern Med, February 21, 2006; 144(4): 229 - 238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Robinson, B. Smith, N. Maheshwari, and H. Schrott Pleiotropic Effects of Statins: Benefit Beyond Cholesterol Reduction?: A Meta-Regression Analysis J. Am. Coll. Cardiol., November 15, 2005; 46(10): 1855 - 1862. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Feinbloom and K. A. Bauer Assessment of Hemostatic Risk Factors in Predicting Arterial Thrombotic Events Arterioscler. Thromb. Vasc. Biol., October 1, 2005; 25(10): 2043 - 2053. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Zalewski and C. Macphee Role of Lipoprotein-Associated Phospholipase A2 in Atherosclerosis: Biology, Epidemiology, and Possible Therapeutic Target Arterioscler. Thromb. Vasc. Biol., May 1, 2005; 25(5): 923 - 931. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. Stuveling, S. J. L. Bakker, H. L. Hillege, P. E. de Jong, R. O. B. Gans, and D. de Zeeuw Biochemical risk markers: a novel area for better prediction of renal risk? Nephrol. Dial. Transplant., March 1, 2005; 20(3): 497 - 508. [Full Text] [PDF]
|
|
|
|
 |
|
 N. P. Kadoglou, S. S. Daskalopoulou, D. Perrea, and C. D. Liapis Matrix Metalloproteinases and Diabetic Vascular Complications Angiology, March 1, 2005; 56(2): 173 - 189. [Abstract] [PDF]
|
|
|
|
 |
|
 V. M. Campese, M. K. Nadim, and M. Epstein Are 3-Hydroxy-3-Methylglutaryl-CoA Reductase Inhibitors Renoprotective? J. Am. Soc. Nephrol., March 1, 2005; 16(3_suppl_1): S11 - S17. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Marz, H. Scharnagl, M. M. Hoffmann, B. O. Boehm, and B. R. Winkelmann The apolipoprotein E polymorphism is associated with circulating C-reactive protein (the Ludwigshafen risk and cardiovascular health study) Eur. Heart J., December 1, 2004; 25(23): 2109 - 2119. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. Scott, R. A.S. Ariens, and P. J. Grant Genetic and Environmental Determinants of Fibrin Structure and Function: Relevance to Clinical Disease Arterioscler. Thromb. Vasc. Biol., September 1, 2004; 24(9): 1558 - 1566. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Rauramaa, P. Halonen, S. B. Vaisanen, T. A. Lakka, A. Schmidt-Trucksass, A. Berg, I. M. Penttila, T. Rankinen, and C. Bouchard Effects of Aerobic Physical Exercise on Inflammation and Atherosclerosis in Men: The DNASCO Study: A Six-Year Randomized, Controlled Trial Ann Intern Med, June 15, 2004; 140(12): 1007 - 1014. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. G. Futterman and L. Lemberg STATIN PLEIOTROPY: FACT OR FICTION? Am. J. Crit. Care., May 1, 2004; 13(3): 244 - 249. [Full Text] [PDF]
|
|
|
|
|
|
M. S. Goligorsky and W. Wang Statins' Coat of Many Colors Receives Yet Another Hue J. Am. Soc. Nephrol., April 1, 2004; 15(4): 1098 - 1100. [Full Text] [PDF]
|
|
Article
