Relationship between effects of statins, aspirin and anglotensin II modulators on high-sensitive C-reactive protein levels

Statins. aspirin and angiotensin II modulators (A II-M: angiotensin-converting enzyme (ACE) inhibitors and angiotensin II type I receptor blockades) may have an anti-inflammatory effect, but the relationship between the effects of statins, aspirin and A II-M on high-sensitive C-reactive protein (hs-CRP) levels remains to be determined. We examined serum hs-CRP levels in consecutive patients with stable ischemic heart disease (IHD) (n = 1231; 65+/-9 years; male/female, 927/304) and without IHD (17 = 226; 64+/-9 years; male/female, 117/109). Blood samples were collected on the day of catheterization. The hs-CRP levels were significantly higher in the IHD than in the non-IHD patients (0.32+/-0.52 vs. 0.24+/-0.29 mg/dl, P<0.05). Treatment with statins was associated with significantly lower hs-CRP levels in both groups (non-IHD, 0.17+/-0.14 vs. 0.26+/-031 mg/dl; MID, 0.27+/-0.34 vs. 0.35+/-0.59 mg/dl; both P < 0.05). hs-CRP levels were significantly lower only in IHD patients treated with A II-M than in those not treated with A II-M (0.28+/-0.34 vs. 0.34+/-0.58 mg/dl, P < 0.05). Aspirin did not have any effect on the hs-CRP level in either group. The hs-CRP levels were significantly lower in IHD patients treated with statins and/or A II-M than those treated with neither statins nor A II-M (statin +/A II-M +, 0.28+/-0.29 mg/dl; statin +/A II-M-, 0.26+/-0.36 mg/dl; statin -/A 11-M+, 0.28+/-0.37 mg/dl; statin -/A II-M-, 0.38+/-0.66 mg/dl; P< 0.01). These results indicate that statins and A II-M, but not aspirin, in commonly used doses have an anti-inflammatory action as assessed by measurement of CRP levels in IHD patients. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.