Inflammation, Pravastatin, and the Risk of Coronary Events After Myocardial Infarction in Patients With Average Cholesterol Levels

• DOI: 10.1161/01.cir.98.9.839
• Publication Date: 2012-06-12T00:41:02Z
• Authors: Paul M. Ridker; Nader Rifai; Marc A. Pfeffer; Frank M. Sacks; Lemuel A. Moye; Steven Goldman; Greg C. Flaker; Eugene Braunwald
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

We studied whether inflammation after myocardial infarction (MI) is a risk factor for recurrent coronary events and randomized treatment with pravastatin reduces that risk.A nested case-control design was used to compare C-reactive protein (CRP) serum amyloid A (SAA) levels in prerandomization blood samples from 391 participants the Cholesterol Recurrent Events (CARE) trial who subsequently developed nonfatal MI or fatal event (cases) an equal number of age- sex-matched remained free these during follow-up (control subjects). Overall, CRP SAA were higher among cases than control subjects (for P=0.05; P=0.006) such those highest quintile had relative (RR) 75% lowest RR= 1.77, P=0.02; 1.74, P=0.02). The study group consistent evidence (elevation both SAA) randomly assigned placebo (RR=2.81, P=0.007); this estimate greater product individual risks associated assignment alone. In stratified analyses, association between significant (RR=2.11, P=0.048) but attenuated nonsignificant (RR=1.29, P=0.5).Evidence increased events. Therapy may decrease risk, observation nonlipid effect agent.