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Relationship Between Uncontrolled Risk Factors and C-Reactive Protein Levels in Patients Receiving Standard or Intensive Statin Therapy for Acute Coronary Syndromes in the PROVE IT-TIMI 22 Trial

Kausik K. Ray, MRCP, MD^_*, Christopher P. Cannon, MD, FACC^_*,_*, Richard Cairns, MSc, David A. Morrow, MD, MPH^_*, Nader Rifai, PhD, Ajay J. Kirtane, MD, Carolyn H. McCabe, BS^_*, Allan M. Skene, PhD, C. Michael Gibson, MS, MD, Paul M. Ridker, MD, MPH^_*, Eugene Braunwald, MD, MACC^_* for the PROVE IT-TIMI 22 Investigators

^_* Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts
Nottingham Clinical Research Group, Boston, Massachusetts
Children’s Hospital, Boston, Massachusetts
Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts

View larger version (28K): [in a new window]   Figure 1 The correlation between median C-reactive protein (CRP) level and 95% confidence interval (CI) (log scale, y axis) across a range of metabolic risk factors (x axis) is shown for the whole cohort using a Loess plot: (A) versus glucose (mg/dl), (B) versus triglycerides (TG) (mg/dl), (C) versus high-density lipoprotein (HDL) (mg/dl), (D) versus body mass index (BMI), (E) versus systolic blood pressure (mm Hg), (F) versus diastolic blood pressure (mm Hg). ATP = Adult Treatment Panel; WHO = World Health Organization.

View larger version (18K): [in a new window]   Figure 2 The correlation between median C-reactive protein (CRP) level and 95% confidence interval (CI) (log scale, y axis) is shown using a Loess plot against low-density lipoprotein (LDL) (mg/dl) for intensive and standard statin therapy.

View larger version (24K): [in a new window]   Figure 3 The interaction between quartiles of low-density lipoprotein (LDL) and glucose on C-reactive protein (CRP) levels (intensive statin therapy arm).

View larger version (15K): [in a new window]   Figure 4 The relationship between the number of uncontrolled risk factors present and the median C-reactive protein (CRP) level for standard and intensive therapy. Risk factors were defined as body mass index (BMI) >25 kg/m2, triglycerides >150 mg/dl, high-density lipoprotein (HDL) <50 mg/dl, glucose >110 mg/dl, blood pressure (BP) >130/85 mm Hg, low-density lipoprotein (LDL) 70 mg/dl, current smoker. p < 0.0001 across the range of risk factors for each statin regimen.

View larger version (19K): [in a new window]   Figure 5 (A) The relationship between the number of uncontrolled risk factors present and median C-reactive protein (CRP) level for standard and intensive therapy in patients with low-density lipoprotein (LDL) <70 mg/dl. Across the range of risk factors, p < 0.0001 for atorvastatin 80 mg and p = 0.002 for pravastatin 40 mg. (B) The relationship between the number of uncontrolled risk factors present and median CRP for standard and intensive therapy in patients with LDL 70 mg/dl. Risk factors at target were defined as body mass index (BMI) >25 kg/m2, triglycerides >150 mg/dl, high-density lipoprotein (HDL) <50 mg/dl, glucose >110 mg/dl, blood pressure (BP) >130/85 mm Hg, current smoker. p < 0.0001 across the range of risk factors for each statin regimen.