Effect of Statins on Serum level of hs-CRP and CRP in Patients with Cardiovascular Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Tahmineh Kandelouei,Amirhossein Sahebkar,Bahman Razi,Tannaz Jamialahmadi,Saeed Aslani,Mahdieh Fasihi,Sajad Shafiekhani,Željko Reiner,Keyhan Mohammadi,Danyal Imani,Mitra Abbasifard

doi:10.1155/2022/8732360

Abstract

Background Several studies have reported that statins have anti-inflammatory effects. Nevertheless, results of clinical trials concerning the effect of statins on the levels of C-reactive protein (CRP) and high-sensitivity CRP (hs-CRP) have been inconsistent. Therefore, we performed a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the effect of statins on CRP and hs-CRP levels in patients with cardiovascular diseases (CVDs). Methods Literature search of the major databases was performed to find eligible RCTs assessing the effect of statins on serum levels of CRP and hs-CRP from the inception until the last week of April 2021. The effect sizes were determined for weighted mean difference (WMD) and 95% confidence intervals (CI). Results 26 studies were identified (3010 patients and 2968 controls) for hs-CRP and 20 studies (3026 patients and 2968 controls) for CRP. Statins reduced the serum levels of hs-CRP (WMD = −0.97 mg/L; 95% CI: -1.26 to -0.68 mg/L; P < 0.001) and CRP (WMD = −3.05 mg/L; 95% CI: -4.86 to -1.25 mg/L; P < 0.001) in patients with CVDs. Statins decreased the serum levels of hs-CRP in patients receiving both high-intensity and moderate/low-intensity treatments with these drugs. In addition, the duration of treatment longer than 10 weeks decreased hs-CRP levels. Only high-intensity statin treatment could marginally decrease serum levels of CRP in CVDs patients. Conclusions This meta-analysis showed the efficacy of statins to reduce the concentrations of CRP and hs-CRP in patients with different types of CVDs.

Highlights

Statins, which are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, are broadly used as lipid-lowering drugs in patients with cardiovascular diseases (CVDs) [1, 2]
After excluding 210 duplicate publications and removing 5513 irrelevant publications based on titles/abstracts on 127 studies, full-text screening was performed. 96 were excluded based on the inclusion criteria because they were reviews or did not report sufficient or extractable data or did not have a control group
All included studies were performed in this century, and they were performed in different countries including China, Taiwan, Korea, Lebanon, Japan, Australia, the USA, Brazil, Argentina, the UK, Ireland, Greece, Russia, Italy, Poland, Germany, Czech Republic, and Turkey

Summary

Introduction

Statins, which are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, are broadly used as lipid-lowering drugs in patients with cardiovascular diseases (CVDs) [1, 2]. Results of clinical trials concerning the effect of statins on the levels of C-reactive protein (CRP) and high-sensitivity CRP (hs-CRP) have been inconsistent. We performed a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the effect of statins on CRP and hs-CRP levels in patients with cardiovascular diseases (CVDs). Literature search of the major databases was performed to find eligible RCTs assessing the effect of statins on serum levels of CRP and hs-CRP from the inception until the last week of April 2021. Statins reduced the serum levels of hs-CRP (WMD = −0:97 mg/L; 95% CI: -1.26 to -0.68 mg/L; P < 0:001) and CRP (WMD = −3:05 mg/L; 95% CI: -4.86 to -1.25 mg/L; P < 0:001) in patients with CVDs. Statins decreased the serum levels of hs-CRP in patients receiving both high-intensity and moderate/low-intensity treatments with these drugs.

Methods

Results

Discussion

Conclusion