The Effect of Different Statin‐Based Lipid‐Lowering Strategies on C‐Reactive Protein Levels in Patients With Stable Coronary Artery Disease

Abstract

ABSTRACTBackgroundStatins are lipid‐lowering drugs with favorable anti‐inflammatory effects. This study aimed to explore different statin‐based lipid‐lowering strategies to reduce high‐sensitivity C‐reactive protein (hs‐CRP).HypothesisThe hypothesis is that different statin‐based lipid‐lowering strategies might reduce hs‐CRP.MethodsThis retrospective study included 3653 patients who underwent percutaneous coronary intervention (PCI). Three statin‐based lipid‐lowering strategies were investigated, including different types of statins (atorvastatin vs. rosuvastatin), statin combined with ezetimibe therapy (vs. without), and intensive statin therapy (vs. regular). The hs‐CRP levels and blood lipid indicators were measured at baseline and after 1‐month lipid‐lowering therapy. Multivariable linear regression analysis and structural equation mode analysis were conducted to verify the association between different lipid‐lowering strategies, Δhs‐CRP (%) and ΔLDL‐C (%).ResultsTotally, 3653 patients were enrolled with an average age of 63.81 years. Multivariable linear regression demonstrated that statin combined with ezetimibe therapy was significantly associated with decreased Δhs‐CRP (%) (β = −0.253, 95% CI: [−0.501 to −0.005], p = 0.045). The increased ΔLDL‐C (%) was an independent predictor of elevated levels of Δhs‐CRP (%) (β = 0.487, 95% CI: [0.15−0.824], p = 0.005). Furthermore, structural equation model analysis proved that statin combined with ezetimibe therapy (β = −0.300, p < 0.001) and intensive statin therapy (β = −0.032, p = 0.043) had an indirect negative effect on Δhs‐CRP via ΔLDL‐C.ConclusionsCompared with routine statin use, statin combined with ezetimibe therapy and intensive statin therapy could further reduce hs‐CRP levels.