scholarly journals The Effect of Statins on C-Reactive Protein in Stroke Patients: A Systematic Review of Clinical Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Babak Alikiaii ◽  
Zahra Heidari ◽  
Mohammad Bagherniya ◽  
Gholamreza Askari ◽  
Thozhukat Sathyapalan ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Statin Therapy ◽  
Methodological Approach ◽  
Cholesterol Concentration ◽  
Lipid Lowering ◽  
C Reactive Protein ◽  
Stroke Patients ◽  
Reactive Protein ◽  
Anti Inflammatory ◽  
Hs Crp

Background. Statins reportedly have anti-inflammatory effects aside from their lipid-lowering impact. We investigated the effects of statin therapy on the level of C-reactive protein (CRP) or highly sensitive CRP (hs-CRP), a liver-derived marker of systemic inflammation, among stroke patients. Methods. An online search was performed in Scopus, PubMed/MEDLINE, ISI Web of Science, and Google Scholar up to November 2020 to recognize clinical trials investigating the effects of statins on the CRP level in stroke patients. Results. Overall, nine studies (11 treatment arms) with 1659 participants met the inclusion criteria. Six out of 9 studies (8 out of 11 arms) were categorized as studies with a high-quality methodological approach using the Cochrane Collaboration’s tool. Data from 5 treatment arms indicated a significant decrease in CRP concentration, and in one treatment arm, CRP concentration did not suggest any considerable alteration following statin therapy. Moreover, two treatment arms showed a significant reduction in hs-CRP concentration and three treatment arms revealed no significant alteration in hs-CRP concentration following statin therapy. Generally, results were heterogeneous and independent of the type of statin, statin dose, treatment duration, and changes in plasma low-density lipoprotein cholesterol concentration. Conclusion. The results suggest that statin therapy could reduce and, therefore, could be considered in these patients as potential anti-inflammatory agents.

scholarly journals Efficacy of Polyunsaturated Fatty Acids on Inflammatory Markers in Patients Undergoing Dialysis: A Systematic Review with Network Meta-Analysis of Randomized Clinical Trials

2019 ◽  
Vol 20 (15) ◽  
pp. 3645 ◽  
Author(s):  
Po-Kuan Wu ◽  
Shu-Ching Yeh ◽  
Shan-Jen Li ◽  
Yi-No Kang
Keyword(s):  
Fatty Acids ◽  
Clinical Trials ◽  
Vitamin E ◽  
Polyunsaturated Fatty Acids ◽  
Inflammatory Markers ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp

The effects of polyunsaturated fatty acids (PUFAs) on inflammatory markers among patients receiving dialysis have been discussed for a long time, but previous syntheses made controversial conclusion because of highly conceptual heterogeneity in their synthesis. Thus, to further understanding of this topic, we comprehensively gathered relevant randomized clinical trials (RCTs) before April 2019, and two authors independently extracted data of C-reactive protein (CRP), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) for conducting network meta-analysis. Eighteen eligible RCTs with 962 patients undergoing dialysis were included in our study. The result showed that with placebo as the reference, PUFAs was the only treatment showing significantly lower CRP (weighted mean difference (WMD): −0.37, 95% confidence interval (CI): −0.07 to −0.68), but the CRP in PUFAs group was not significantly lower than vitamin E, PUFAs plus vitamin E, or medium-chain triglyceride. Although no significant changes were noted for hs-CRP and IL-6 levels, PUFAs showed the best ranking among treatments according to surface under the cumulative ranking. Therefore, PUFAs could be a protective option for patients receiving dialysis in clinical practice.

Abstract WP465: Effect of Chocolate Containing 86% Cacao and Much Polyphenol to Improve Level of Alertness in Acute Stroke Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Takahisa Mori ◽  
Kazuhiro Yoshioka ◽  
Nozomi Chiba
Keyword(s):  
Nutritional Status ◽  
Acute Stroke ◽  
High Sensitivity ◽  
Dark Chocolate ◽  
C Reactive Protein ◽  
Stroke Patients ◽  
Reactive Protein ◽  
Level Of Consciousness ◽  
Hs Crp ◽  
Gcs Score

Introduction: Level of alertness in acute stroke patients is often deteriorated during hospitalization, even though they can orally eat food on admission and their stroke is not severe. Then, it is difficult to improve their level of alertness. If their level of alertness is not improved, their nutritional status is probably deteriorated. Hypothesis: Dark chocolate 5g tablet containing 86% cacao and 147mg polyphenol can improve level of alertness and prevent deterioration of nutritional status. Methods: We included acute stroke patients for retrospective analysis who 1) were admitted between August 2017 and July 2018, 2) presented alert consciousness on admission and orally eat food then, 3) underwent blood examination on admission, the 3rd day and 7th day, 4) presented mild deterioration of level of alertness during hospitalization and 5) took dark chocolate 5g containing 86% cacao and 147mg polyphenol twice a day. We evaluated patients’ features, Glasgow Coma Scale (GCS) as level of consciousness, albumin (Alb), prealbumin (PreAlb), high-sensitivity C-reactive protein (hs-CRP) on admission, on the initial chocolate day and on the 7th day. Results: Eighteen patients met our inclusive criteria and were analyzed. The median age, GCS score, body mass index, blood glucose (BG), hs-CRP, Alb and PreAlb were 85 years, 14, 21.8 kg/m2, 119 mg/dl, 0.1165 mg/dl, 3.9 g/dl and 20.4 mg/dl, respectively. They started to eat 86% cacao chocolate 5g supplementation twice a day median on the 3rd day. On the 3rd day when chocolate was started, their median GCS score, Alb and PreAlb decreased to13 (p<0.0001), 3.45 mg/dl (p<0.0001) and 19.1 mg/dl (p<0.001), respectively, and their median hs-CRP increased to 0.4325 mg/dl (p<0.05). On the 7th day, their median GCS increased to 14 (0.0001), median Alb, PreAlb and hs-CRP levels were 3.45 mg/dl (ns), 16.5 g/dl (ns) and 0.506 mg/dl (ns). Conclusion: Dark chocolate containing 86% cacao and 147mg polyphenol probably improved level of alertness and prevented further deterioration of nutritional status in patients who could orally eat food.

Vitamin C supplementation and C-reactive protein levels: Findings from a systematic review and meta-analysis of clinical trials

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Maryam Safabakhsh ◽  
Mohammad Reza Emami ◽  
Mohammad Zeinali Khosroshahi ◽  
Omid Asbaghi ◽  
Shaghayegh Khodayari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Vitamin C ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Subgroup Analyses ◽  
Vitamin C Supplementation ◽  
Hs Crp

AbstractBackground and purposeC-reactive protein (CRP) is an inflammatory biomarker which prognosticates cardiovascular disease. Previous studies have reached mixed conclusions regarding the effect of vitamin C on reducing CRP or hs-CRP level. The present systematic review and meta-analysis was conducted to resolve these inconsistencies.Materials and methods: Related articles published up to August 2018 were searched through PubMed, Scopus, Ovid, ISI web of science, Embase, and Cochrane databases by relevant keywords. Clinical trials which examined the effect of either vitamin C supplementation or vitamin C-enriched foods on CRP and hs-CRP levels were included. A total of 11 studies with 14 data sets involving 818 subjects were included.ResultsOverall, the pooled analysis revealed that vitamin C could decrease CRP level relative to placebo group (Weighted mean difference [WMD]=−0.73 mg/L: 95% CI: −1.30 to −0.15, p=0.013) with a considerable heterogeneity (I2=98%, p<0.001). Moreover, subgroup analyses revealed that the beneficial effect of vitamin C on CRP level alternation only was found in male (p=0.003), non-smoker (p=0.041), healthy (p=0.029) and younger participants (p=0.010). Vitamin C could improve CRP level only at doses of less than 500 mg/day (p=0.009). Regarding hs-CRP changes, the pooled analysis did not show any significant effect of vitamin C (WMD=−0.65 mg/L: 95% CI: −2.03 to 0.72, p=0.35). This finding was confirmed by all subgroup analyses expect for high quality articles in which hs-CRP level was elevated after vitamin C supplementation (p=0.026).ConclusionIn conclusion, supplementation with vitamin C might have a significant effect only on CRP reduction. Further studies are needed to confirm this effect.

scholarly journals Clinical Treatment Experience in Severe and Critical COVID-19

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Mingliang Li ◽  
Donglin Zhu ◽  
Jianghua Yang ◽  
Ling Yan ◽  
Zhiyong Xiong ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Treatment Time ◽  
Cure Rate ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Anti Inflammatory ◽  
Hs Crp ◽  
Special Hospital ◽  
D Dimer ◽  
Main Strategy

Compared with other deadly diseases, the coronavirus disease 2019 (COVID-19) is highly infectious with a relatively low mortality rate. Although critical cases account for only 5% of cases, the mortality rate for the same is nearly 50%. Therefore, the key to the COVID-19 treatment is to effectively treat severe patients and reduce the transition from severe to critical cases. A retrospective study was carried out to evaluate outcomes of treatment in patients with severe and critical COVID-19 admitted to a COVID-19 special hospital in Wuhan, China. A total of 75 severe and critical COVID-19 patients were admitted and treated with immunomodulation as the main strategy combined with anti-inflammatory therapy and appropriate anticoagulation. Leukocyte levels in patients with 7-14 days of onset to diagnosis were significantly lower than in those with >14 days. Higher levels of globulin and D-dimer and lower lymphocyte levels were found in the older age group (>65 years) than in the middle-aged group (50-64 years). Patients with comorbidity had higher levels of inflammatory indicators. After treatment, 65 (86.67%) patients were cured, 7 (9.33%) had improved, and 3 (4.00%) had died. Median hospitalization duration was 23 days. Fatal cases showed continuously increased levels of globulin, dehydrogenase (LDH), hypersensitive C-reactive protein (hs-CRP), D-dimer, and cytokines during treatment. Time from onset to diagnosis, age, and comorbidity are important influencing factors on treatment effects. The occurrence of immunosuppression, “cytokine storm,” and thrombosis may be an important cause of death in severely infected cases. In conclusion, high cure rate and low mortality suggested that immunomodulation combined with anti-inflammatory therapy and appropriate anticoagulant therapy is a good strategy for treatment of patients with severe and critical COVID-19.

scholarly journals Association of high-sensitivity C-reactive protein and long-term mortality may differ from lipoprotein(a) levels among patients undergoing coronary angiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Guo ◽  
L Lei ◽  
M Ying ◽  
B Wang ◽  
J Liu ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
High Sensitivity ◽  
Hazard Ratio ◽  
Cholesterol Concentration ◽  
C Reactive Protein ◽  
Lipoprotein A ◽  
Reactive Protein ◽  
Hs Crp ◽  
Long Term Mortality

Abstract Background The use of high-sensitivity C-reactive protein (hs-CRP) as an inflammation biomarker in predicting long-term mortality remains controversial. We aimed to investigate whether the association of hs-CRP with long-term mortality differs from another inflammation biomarker, lipoprotein(a), in patients undergoing coronary angiography (CAG). Methods A total of 2422 patients undergoing CAG were included in the final analysis from a prospective, observational study. We divided them into 4 groups according to hs-CRP level (high ≥4.8 mg/l, low &lt;4.8 mg/l) and lipoprotein(a) level (high ≥17 mg/dl, low &lt;17 mg/dl). Results The overall incidence of all-cause long-term mortality was 133/2422 (5.5%). In the high lipoprotein(a) group, after adjusting for LDL-cholesterol concentration (LDL-C), age, sex, smoking status, diabetes mellitus and estimated glomerular filtration rate (eGFR), a high hs-CRP level was an independent predictor of all-cause long-term mortality (hazard ratio: 2.01; 95% CI: 1.13–3.54; p=0.02). In the low lipoprotein(a) group, a similar result was not found (hazard ratio: 1.42; 95% CI: 0.92–2.01; p=0.24). Conclusions Our data suggested that the association of hs-CRP with all-cause long-term mortality may differ from lipoprotein(a) levels among patients undergoing CAG. In addition to hs-CRP, a high lipoprotein(a) level might be a simultaneous intervention target for improving long-term prognosis in the future. Funding Acknowledgement Type of funding source: None

High sensitivity C-reactive protein (hsCRP) and its implications in cardiovascular outcomes

2020 ◽  
Vol 26 ◽  
Author(s):  
Andrea Denegri ◽  
Giuseppe Boriani
Keyword(s):  
Randomized Clinical Trials ◽  
Current Knowledge ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
Active Role ◽  
Lipid Lowering ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Anti Inflammatory

: Atherosclerosis and its fearsome complications represent the first cause of morbidity and mortality worldwide. Over the last two decades, several evidences have been accumulated, suggesting a central role for inflammation in atheroma development. High sensitivity C-reactive protein (hsCRP) is a well-established marker of cardiovascular (CV) disease; high levels of hsCRP have been associated with adverse CV outcome after acute coronary syndrome (ACS) and, despite some controversy, an active role for hsCRP in initiation and development of the atherosclerotic plaque has been also proposed. Randomized clinical trials focusing on hsCRP have been crucial in elucidating the anti-inflammatory effects of statin therapy. Thus, hsCRP has been progressively considered a real CV risk factor likewise to low-density lipoprotein cholesterol (LDL-C), rising the concept of residual CV inflammatory risk. Subsequent research has been designed to investigate potential new targets of atherothrombotic protection. Despite clinical usefulness of hsCRP is widely recognized, hsCRP may not represent the ideal target of specific anti-inflammatory therapies. Clinical investigations, therefore, have focused also on other inflammatory mediators, restricting hsCRP to an indicator rather than a therapeutic target. The aim of the present review is to provide an illustrative overview on the current knowledge of atherosclerosis and inflammation, highlighting the most representative clinical studies of lipid lowering- and antiinflammatory therapies focused on hsCRP in CV diseases.

scholarly journals Hubungan Profil Lipid dan Kadar High-Sensitivity C-Reactive Protein dengan Outcome Pasien Stroke Iskemik Akut

2020 ◽  
Vol 3 (2) ◽  
pp. 48
Author(s):  
Stefanus Erdana Putra ◽  
Fauzi Novia Isnaening Tyas ◽  
Muhammad Hafizhan ◽  
Raden Ajeng Hanindia Riani Prabaningtyas ◽  
Diah Kurnia Mirawati
Keyword(s):  
Ischemic Stroke ◽  
Lipid Profile ◽  
Barthel Index ◽  
Density Lipoprotein ◽  
High Sensitivity ◽  
National Institutes Of Health ◽  
C Reactive Protein ◽  
Stroke Patients ◽  
Reactive Protein ◽  
Hs Crp

<p><strong>Pendahuluan:</strong><strong> </strong><em>Stroke</em> adalah penyebab utama kecacatan jangka panjang dengan dampak klinis dan sosial ekonomi yang signifikan di seluruh dunia. Hiperlipidemia dan inflamasi memainkan peranan penting dalam patofisiologi <em>stroke</em> iskemik. Meskipun <em>high-sensitivity C-Reactive Protein </em>(hs-CRP) dan kadar lipid merupakan penentu risiko penyakit pembuluh darah, kekuatan penggunaan <em>biomarker</em> ini dalam penentuan prognosis <em>stroke </em>iskemik belum dapat dipastikan. Penelitian ini bertujuan untuk mengetahui hubungan kadar hs-CRP dan profil lipid pada pasien <em>stroke </em>iskemik akut di Rumah Sakit Universitas Sebelas Maret dan memahami hubungan antara <em>biomarker</em> tersebut dengan <em>outcome</em> jangka pendek.</p><p><strong>Metode penelitian:</strong><strong> </strong>Penelitian <em>cross-sectional</em> dilakukan pada 34 pasien dengan serangan <em>stroke</em> iskemik pertama kali. Profil lipid dan hs-CRP diukur pada hari pertama masuk rumah sakit. Defisit neurologis diukur menggunakan <em>National Institutes of Health Stroke Scale</em> (NIHSS) dan <em>outcome</em> diukur menggunakan Barthel <em>Index</em> pada hari ke-7 perawatan di unit <em>stroke</em>. Selanjutnya, kadar serum hs-CRP dan profil lipid dianalisis korelasinya dengan defisit neurologis dan <em>outcome</em> jangka pendek.</p><p><strong>Hasil penelitian:</strong><strong> </strong>Pasien <em>stroke</em> iskemik memiliki kadar hs-CRP, kolesterol total (TC), trigliserida (TG), <em>low-density lipoprotein</em> (LDL) yang lebih tinggi; serta kadar <em>high-density lipoprotein</em> (HDL) yang lebih rendah dari kriteria normal. Berdasarkan uji korelasi Pearson, LDL memiliki korelasi signifikan dengan NIHSS (r = 0,447; p = 0,008) sedangkan hs-CRP memiliki korelasi signifikan yang lebih kuat dengan Barthel <em>Index </em>daripada NIHSS (r = -0,412; p = 0,015). TC dan HDL juga memiliki korelasi signifikan dengan NIHSS.</p><p><strong>Kes</strong><strong>impulan:</strong><strong> </strong>Penelitian ini menunjukkan bahwa profil lipid dan hs-CRP dapat digunakan sebagai prediktor prognosis <em>outcome stroke </em>iskemik akut.</p><p> </p><p>Introduction: Stroke is the leading cause of long-term disability with significant clinical and socioeconomic impact worldwide. Hyperlipidemia and inflammation play major roles in ischemic stroke. While high-sensitivity C-Reactive Protein (hs-CRP) and lipid levels are established risk determinants for vascular disease, the relative strength of these biomarkers for ischemic stroke is uncertain. The purpose of this study is to investigate the association of hs-CRP levels and lipid profile in acute ischemic stroke patients and understand correlation between those markers and short-term outcome.</p><p>Methods: This was a cross-sectional study of 34 first-timer ischemic stroke patients. Lipid profiles and hs-CRP were measured on admission day. The neurological deficit was quantified using National Institutes of Health Stroke Scale (NIHSS) and outcome was quantified using Barthel Index at the 7th day in stroke unit. Serum level of hs-CRP and lipid profile were estimated and correlated with neurological deficit and short-term outcome.</p><p>Results: Ischemic stroke patients had higher levels of hs-CRP, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL); and lower level of high-density lipoprotein (HDL) than normal criteria. Based on Pearson correlation test, LDL had significant correlation with NIHSS (r=0.447; p=0.008) while hs-CRP had stronger significant correlation with Barthel Index than NIHSS (r=-0.412; p=0.015). TC and HDL also had significant correlation with NIHSS.</p><p>Conclusions: This research suggests that lipid profile and hs-CRP can be used as predictors of prognosis for acute ischemic stroke outcome. Keywords: Barthel index, C-reactive protein, National Institutes of Health Stroke Scale, lipid profile, ischemic stroke.</p>

scholarly journals Interplay between hypercholesterolaemia and inflammation in atherosclerosis: Translating experimental targets into clinical practice

2018 ◽  
Vol 25 (9) ◽  
pp. 948-955 ◽  
Author(s):  
José Tuñón ◽  
Magnus Bäck ◽  
Lina Badimón ◽  
Marie-Luce Bochaton-Piallat ◽  
Bertrand Cariou ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Cardiovascular Events ◽  
Density Lipoprotein ◽  
Cardiovascular Prevention ◽  
Lipid Lowering ◽  
Receptor Protein ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Future ◽  
Anti Inflammatory

Dyslipidaemia and inflammation are closely interconnected in their contribution to atherosclerosis. In fact, low-density lipoprotein (LDL)-lowering drugs have anti-inflammatory effects. The Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) has shown that interleukin (IL)-1β blockade reduces the incidence of cardiovascular events in patients with previous myocardial infarction and C-reactive protein levels >2 mg/L. These data confirm the connection between lipids and inflammation, as lipids activate the Nod-like receptor protein 3 inflammasome that leads to IL-1β activation. LDL-lowering drugs are the foundation of cardiovascular prevention. Now, the CANTOS trial demonstrates that combining them with IL-1β blockade further decreases the incidence of cardiovascular events. However, both therapies are not at the same level, given the large evidence showing that LDL-lowering drugs reduce cardiovascular risk as opposed to only one randomized trial of IL-1β blockade. In addition, IL-1β blockade has only been studied in patients with C-reactive protein >2 mg/L, while the benefit of LDL-lowering is not restricted to these patients. Also, lipid-lowering drugs are not harmful even at very low ranges of LDL, while anti-inflammatory therapies may confer a higher risk of developing fatal infections and sepsis. In the future, more clinical trials are needed to explore whether targeting other inflammatory molecules, both related and unrelated to the IL-1β pathway, reduces the cardiovascular risk. In this regard, the ongoing trials with methotrexate and colchicine may clarify whether the cardiovascular benefit of IL-1β blockade extends to other anti-inflammatory mechanisms. A positive result would represent a major change in the future treatment of atherosclerosis.

Atorvastatin decreases high-sensitivity C-reactive protein in multiple sclerosis

2008 ◽  
Vol 14 (7) ◽  
pp. 981-984 ◽  
Author(s):  
J Sellner ◽  
I Greeve ◽  
HP Mattle
Keyword(s):  
Multiple Sclerosis ◽  
High Sensitivity ◽  
Serum Levels ◽  
Interferon Β ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Reductase Inhibitors ◽  
Relapsing Remitting ◽  
Anti Inflammatory ◽  
Hs Crp

The anti-inflammatory potential of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, as reflected by modulation of C-reactive protein (CRP), might be beneficial in the treatment of patients with multiple sclerosis (MS). We evaluated serum levels of high-sensitivity (hs)-CRP in relapsing–remitting MS patients receiving interferon-β 1b and atorvastatin as add-on therapy. This study shows that interferon-β treatment is associated with increased serum levels of hs-CRP in MS patients ( P < 0.01). In contrast, when atorvastatin is added to interferon-β, hs-CRP serum levels decrease to the normal range ( P < 0.05), indicating an anti-inflammatory action of atorvastatin in MS. However, whether add-on treatment with atorvastatin modifies the course of MS remains to be investigated.

Sign in / Sign up

Export Citation Format

Share Document