Effects of atorvastatin versus other statins on fasting and postprandial c-reactive protein and lipoprotein -: Associated phospholipase A2 in patients with coronary heart disease versus control subjects

The effects of atorvastatin (40 mg/day) versus placebo on fasting and postprandial plasma levels of high-sensitivity C-reactive protein (hs-CRP) and lipoprotein-associated phospholipase A(2) (Lp-PLA2) were examined over 36 weeks in 84 patients who had coronary heart disease, and low-density lipoprotein cholesterol levels > 130 mg/dl and compared directly with the effects of fluvastatin, lovastatin, pravastatin, and simvastatin. Results were also compared with those obtained in age- and gender-matched control subjects,(n = 84). Feeding increased median hs-CRP levels by 2% in patients (p = NS) and 22% in controls (p < 0.01) and increased mean Lp-PLA2 values by, 9% in patients (p = NS) but decreased values by 21 % in controls (p < 0.0001). Patients had 5 1 % higher median hs-CRP values and 29% higher mean Lp-PLA2 values than did controls (p < 0.05 for hs-CRP and Lp-PLA2) in the fasting state; however, Lp-PLA2 values were 62% higher (p < 0.0001) in the fed state in patients compared with controls. Atorvastatin decreased median hs-CRP levels by 32% (p < 0.01) and mean Lp-PLA2 values by 26% in patients (p < 0.0001), with similar decreases in the fed state, and none of the other statins had any significant effect on these parameters. Change in Lp-PLA2 was significantly related to change in low-density lipoprotein cholesterol (p < 0.01), with no significant relations with change in hs-CRP. Our data indicate greater differences in patients with coronary heart disease compared with controls in Lp-PLA2 in the fed state than in the fasting state and that atorvastatin is more effective than fluvastatin, lovastatin, provastatin, or simvastatin for decreasing not only low-density lipoprotein cholesterol but. also hs-CRP and Lp-PLA2. (c) 2005 by Excerpta Medica Inc.