The Effect of Statin Therapy on Atherosclerosis and hsCRP in Patients with lschemic Stroke

Abstract

Scientific Background: High plasma concentrations of low-density lıpoprotein (LOL-cholesterol), are one of the principal risk factors for atherosclerosis. Atherosclerosis is also an inflammatory disease; and increase in C-reactive protein (CRP) has been shown in patients with cerebral ischemia. The anti-inflammatory effect of statins in addition to cholesterol-lowering effect is being studied recently as an intriguing aspect. Objectives: ın this study, we have analyzed the effect of concurrent statin therapy on the relationship between the hsCRP levels and atherosclerosis in patients with acute stroke. Material and Methods: The lipid profile and the plasma levels of hsCRP following three days after stroke were measured in 104 patients with ischemic stroke. The ultrasonographic examination of carotid arteries were performed, and patients were classified as having normal examination, intimal thickening (> 1.2 mm), presence of plaque, and the presence of significant stenosis (>50%). The statistical analysis were done by using the Jonchkeere-Terpstra test, Kruskal Wallis test, Mann-Whitney U test, and chi-square test, as needed.
Results: Out of 104 patients included in the study (52 female and 52 male; mean age of 66.7 + 12.8 years), 91 of them (88%) were on medication with statins. A statistically significant positive relation was observed between carotid atherosclerosis and hsCRP levels (p=0.040). Among all risk factors included, only high-density lipoprotein (HOL) had a significant negatif correlation with the levels of hsCRP (p=0.007). The mean hsCRP levels and the number of patients having increased hsCRP were lower in statin-user group in compared to non-users, but the difference failed to show significant value. The degree of carotid atherosclerosis was positively related with the hsCRP levels in patients on statins (p=0.027), however, such a relation was not present in non-users. When patients were evaluated as statin users and non-users, more advanced carotid artery atherosclerosis were observed in patients without statin medication (p=0.03).
Conclusions: Although a positive correlation between atherosclerosis and hsCRP, and a negative correlation between HOL and hsCRP, the effect of statin therapy on atherosclerosis and inflammation is not clear. The additive value of statins on these mechanisms remain to be explored with wide-based and long-term prospective studies.