PREPROCEDURAL HIGH-SENSITIVITY C-REACTIVE PROTEIN DECREASE DURING INTENSIVE ATORVASTATIN THERAPY

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Objective: Proinflammatory status is the risk factor for coronary atherosclerosis progression after coronary stenting (CS). Intensive statin treatment is associated with high-sensitivity C-reactive protein (hsCRP) concentration decline. We aimed to evaluate prognostic significance of preprocedural hsCRP level reduction with intensive statin regimen for coronary atherosclerosis progression during one year after CS. Design and method: We enrolled 102 patients with stable angina who were on list for scheduled CS. Group I (n = 37) patients received atorvastatin 80 mg for 7 days before and 3 months after CS with further dose adjustment according to LDL; group II (n = 65) patients received atorvastatin 20–40 mg/day for LDL goal achievement. HsCRP level was assessed at baseline, before CS and after 1, 3, 6 and 12 months. Coronary atherosclerosis progression was defined as new >50% stenosis or >30% increase of >20% pre-existing stenosis according to coronary angiography (CA) 1 year after CS. Results: Baseline concentration of hsCRP was comparable: 0.21 (0.13;0.38) vs. 0.20 (0.1;0.44) mg/dl in groups I and II, respectively (p>0.05). In group I significant hsCRP level decrease to 0,14 (0.07;0.32) mg/dl, p < 0.05) was determined after 7 days. Coronary atherosclerosis progression was revealed in 10 (41%) patients in group I and in 20 (47%) in group II according to CA. HsCRP level >0.26 was associated with coronary atherosclerosis progression during 12 months (OR 4.2 for total study group, 95% CI 1.4–12.3; p = 0.01). Conclusions: Elevated preprocedural hsCRP level is associated with coronary atherosclerosis progression after CS. Intensive atorvastatin regimen for one week before CS leads to preprocedural hsCRP level reduction.

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