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Effect of lipid-lowering therapies on C-reactive protein levels: a comprehensive meta-analysis of randomized controlled trials

以兹提米比 荟萃分析 随机对照试验 安慰剂 血脂谱 胆固醇转移蛋白 医学 胃肠病学 C反应蛋白 置信区间 内科学 生物标志物 内分泌学 胆固醇 脂蛋白 炎症 化学 生物化学 病理 替代医学
作者
Sining Xie,Federica Galimberti,Elena Olmastroni,Thomas F. Lüscher,Stefano Carugo,Alberico L. Catapano,Manuela Casula,Alberico L. Catapano,Sining Xie,Federica Galimberti,Elena Olmastroni,Sining Xie,Christoph Wanner,Salim Yusuf,Aldo P. Maggioni,Adrienne Kirby,Hiroshi Ogawa,Ellen K. Hoogeveen,Ingebjørg Seljeflot,Francine K. Welty,Michal Benderly,JoAnn E. Manson,Kathy Wolski,Christopher P. Cannon,Frederick J. Raal,David Kallend,JoAnne M. Foody,Michael J. Louie
出处
期刊:Cardiovascular Research [Oxford University Press]
卷期号:120 (4): 333-344 被引量:6
标识
DOI:10.1093/cvr/cvae034
摘要

Abstract Chronic low-degree inflammation is a hallmark of atherosclerotic cardiovascular (CV) disease. To assess the effect of lipid-lowering therapies on C-reactive protein (CRP), a biomarker of inflammation, we conducted a meta-analysis according to the PRISMA guidelines. Databases were searched from inception to July 2023. Inclusion criteria were: (i) randomized controlled trials (RCTs) in human, Phase II, III, or IV; (ii) English language; (iii) comparing the effect of lipid-lowering drugs vs. placebo; (iv) reporting the effects on CRP levels; (v) with intervention duration of more than 3 weeks; (vi) and sample size (for both intervention and control group) over than 100 subjects. The between-group (treatment-placebo) CRP absolute mean differences and 95% confidence intervals were calculated for each drug class separately. A total of 171 668 subjects from 53 RCTs were included. CRP levels (mg/L) were significantly decreased by statins [−0.65 (−0.87 to −0.43), bempedoic acid; −0.43 (−0.67 to −0.20), ezetimibe; −0.28 (−0.48 to −0.08)], and omega-3 fatty acids [omega3FAs, −0.27 (−0.52 to −0.01)]. CRP was reduced by −0.40 (−1.17 to 0.38) with fibrates, although not statistically significant. A slight increase of CRP concentration was observed for proprotein convertase subtilisin/kexin type 9 inhibitors [0.11 (0.07–0.14)] and cholesteryl-ester transfer protein inhibitors [0.10 (0.00–0.21)], the latter being not statistically significant. Meta-regression analysis did not show a significant correlation between changes in CRP and LDL cholesterol (LDL-C) or triglycerides. Statins, bempedoic acid, ezetimibe, and omega3FAs significantly reduce serum CRP concentration, independently of LDL-C reductions. The impact of this anti-inflammatory effect in terms of CV prevention needs further investigation.
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