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C-reactive protein, bezafibrate, and recurrent coronary events in patients with chronic coronary heart disease.
Am Heart J. 2007 Dec; 154(6):1095-101.AH

Abstract

BACKGROUND

Elevated C-reactive protein (CRP) levels are related to increased coronary risk in healthy subjects and in patients with acute coronary syndromes. The aims of the present study were to assess the following: (1) the association between CRP and subsequent coronary risk in patients with chronic coronary heart disease (CHD), (2) the effect of long-term bezafibrate treatment on CRP levels, and (3) to evaluate the consequences of change in CRP level over time on subsequent risk.

METHODS

Patients with chronic CHD (n = 3122) were recruited to a secondary prevention study that assessed the efficacy of bezafibrate versus placebo. C-reactive protein was measured in plasma samples collected at prerandomization and after 2 years of follow-up. Mean follow-up time was 6.2 years. Primary end point was fatal and nonfatal myocardial infarction and sudden cardiac death.

RESULTS

Increased baseline CRP levels were associated with increased risk (hazard ratios [HRs] per unit of log-transformed CRP level change) of myocardial infarction (HR 1.17, 95% CI 1.03-1.33), the primary end point (HR 1.19, 95% CI 1.06-1.34), total death (HR 1.19, 95% CI 1.02-1.40) and cardiac death (HR 1.28, 95% CI 1.04-1.59). After 2 years, CRP levels increased by 3.0% (from a mean level of 3.44 mg/L) in the bezafibrate group and by 3.7% (from 3.49 mg/L) in the placebo group. C-reactive protein levels after 2 years were associated with increased subsequent cardiovascular risk.

CONCLUSIONS

Baseline CRP and 2-year CRP levels were associated with subsequent risk of myocardial infarction and death in patients with chronic CHD. Bezafibrate did not reduce CRP levels as compared with placebo.

Authors+Show Affiliations

Cardiology Department, Rabin Medical Center, Petach-Tiqva, Israel. motih@netvision.net.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18035081

Citation

Haim, Moti, et al. "C-reactive Protein, Bezafibrate, and Recurrent Coronary Events in Patients With Chronic Coronary Heart Disease." American Heart Journal, vol. 154, no. 6, 2007, pp. 1095-101.
Haim M, Benderly M, Tanne D, et al. C-reactive protein, bezafibrate, and recurrent coronary events in patients with chronic coronary heart disease. Am Heart J. 2007;154(6):1095-101.
Haim, M., Benderly, M., Tanne, D., Matas, Z., Boyko, V., Fisman, E. Z., Tenenbaum, A., Zimmlichman, R., Battler, A., Goldbourt, U., & Behar, S. (2007). C-reactive protein, bezafibrate, and recurrent coronary events in patients with chronic coronary heart disease. American Heart Journal, 154(6), 1095-101.
Haim M, et al. C-reactive Protein, Bezafibrate, and Recurrent Coronary Events in Patients With Chronic Coronary Heart Disease. Am Heart J. 2007;154(6):1095-101. PubMed PMID: 18035081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - C-reactive protein, bezafibrate, and recurrent coronary events in patients with chronic coronary heart disease. AU - Haim,Moti, AU - Benderly,Michal, AU - Tanne,David, AU - Matas,Zipora, AU - Boyko,Valentina, AU - Fisman,Enrique Z, AU - Tenenbaum,Alexander, AU - Zimmlichman,Reuven, AU - Battler,Alexander, AU - Goldbourt,Uri, AU - Behar,Solomon, Y1 - 2007/09/27/ PY - 2006/11/16/received PY - 2007/07/23/accepted PY - 2007/11/24/pubmed PY - 2007/12/6/medline PY - 2007/11/24/entrez SP - 1095 EP - 101 JF - American heart journal JO - Am Heart J VL - 154 IS - 6 N2 - BACKGROUND: Elevated C-reactive protein (CRP) levels are related to increased coronary risk in healthy subjects and in patients with acute coronary syndromes. The aims of the present study were to assess the following: (1) the association between CRP and subsequent coronary risk in patients with chronic coronary heart disease (CHD), (2) the effect of long-term bezafibrate treatment on CRP levels, and (3) to evaluate the consequences of change in CRP level over time on subsequent risk. METHODS: Patients with chronic CHD (n = 3122) were recruited to a secondary prevention study that assessed the efficacy of bezafibrate versus placebo. C-reactive protein was measured in plasma samples collected at prerandomization and after 2 years of follow-up. Mean follow-up time was 6.2 years. Primary end point was fatal and nonfatal myocardial infarction and sudden cardiac death. RESULTS: Increased baseline CRP levels were associated with increased risk (hazard ratios [HRs] per unit of log-transformed CRP level change) of myocardial infarction (HR 1.17, 95% CI 1.03-1.33), the primary end point (HR 1.19, 95% CI 1.06-1.34), total death (HR 1.19, 95% CI 1.02-1.40) and cardiac death (HR 1.28, 95% CI 1.04-1.59). After 2 years, CRP levels increased by 3.0% (from a mean level of 3.44 mg/L) in the bezafibrate group and by 3.7% (from 3.49 mg/L) in the placebo group. C-reactive protein levels after 2 years were associated with increased subsequent cardiovascular risk. CONCLUSIONS: Baseline CRP and 2-year CRP levels were associated with subsequent risk of myocardial infarction and death in patients with chronic CHD. Bezafibrate did not reduce CRP levels as compared with placebo. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/18035081/C_reactive_protein_bezafibrate_and_recurrent_coronary_events_in_patients_with_chronic_coronary_heart_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(07)00609-6 DB - PRIME DP - Unbound Medicine ER -