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KMID : 1036020120010010021
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지질.동맥경화학회지
2012 Volume.1 No. 1 p.21 ~ p.28
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Effect of Statins on C-reactive Protein, Lipoprotein(a) and Fibrinogen in Hypercholesterolemic Patients
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Cho Jun-Hwan
Kim Kyung-Joon
Lee Wang-Soo
Lee Kwang-Je
Kim Sang-Wook
Kim Tae-Ho
Kim Chee-Jeong
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Abstract
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Objective: C-reactive protein (CRP), lipoprotein (a)[Lp(a)], and fibrinogen are associated with systemic inflammatory reactions. Statins have anti-inflammatory effects. However, the effect of statins on these parameters is inconsistent. We evaluated the effect of statins on inflammatory markers and variables related to changes in these markers.
Methods: A total of 390 hypercholesterolemic patients were enrolled. Atorvastatin (n=112), lovastatin (n=25), pitavastatin (n=49), rosuvastatin (n=20), and simvastatin (n=184) were administered. Lipids, CRP, Lp(a), and fibrinogen levels were measured before and after 2 months of the therapy.
Results: Statins reduced cholesterol, low density lipoprotein (LDL) cholesterol, and triglyceride levels by -28.9±9.1% (P=0.000), -41.4±12.4% (P=0.000), and -11.6±39.4% (P=0.000), respectively and increased high density lipoprotein (HDL) cholesterol level by 2.56±13.2% (P=0.014). CRP levels decreased from 1.23±1.30 to 1.14±1.29 mg/L (P=0.000). Lp(a) levels were not changed (P=0.91) and fibrinogen levels increased from 277.8±54.4 to 282.6±56.9 mg/dL (P=0.042). Changes in CRP levels were associated with baseline CRP levels (r=-0.56, P=0.000) and changes in HDL cholesterol levels (r=-0.14, P=0.005). Changes in Lp(a) levels were associated with changes in triglyceride (r=-0.24, P=0.000) and baseline aspartate aminotransferase level (r=0.12, P=0.015). Changes in fibrinogen levels were associated with baseline fibrinogen levels (r=-0.40, P=0.000), sex (r=0.18, P=0.001), and changes in HDL cholesterol levels (r=-0.15, P=0.003).
Conclusion: Inflammatory markers showed different responses to statins and changes in these markers were associated with different parameters. This finding suggests that anti-inflammatory effect of statin is confined to a specific pathway of inflammation.
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KEYWORD
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C-reactive protein, Statin, Fibrinogen, Lipoprotein, Lipids
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