Jenkins Nicholas P, Keevil Brian G, Hutchinson Ian V, Brooks Nicholas H
University Department of Cardiology, Regional Cardiac Centre, Wythenshawe Hospital, Manchester, United Kingdom.
Am J Med. 2002 Mar;112(4):269-74. doi: 10.1016/s0002-9343(01)01115-9.
C-reactive protein is an important risk factor for coronary artery disease, and plasma concentrations are lowered by treatment with pravastatin and aspirin. We examined whether other cardiovascular drugs that are used in the treatment of ischemic heart disease affect C-reactive protein concentrations.
Plasma C-reactive protein concentration was measured by high sensitivity immunonephelometric assay in 333 consecutive patients with stable angina and confirmed coronary artery disease who underwent diagnostic angiography.
Patients prescribed beta-blockers had significantly lower mean C-reactive protein concentrations than did patients in whom these were not prescribed (by 1.2 mg/L, or 40% difference in geometric mean concentration; P <0.001). This association remained significant (P = 0.03) after excluding patients with contraindications to the use of beta-blockers, and adjusting for the probability of beta-blocker therapy (propensity score) and other clinical predictors of C-reactive protein concentration, including body mass index, high-density lipoprotein cholesterol level, family history of coronary artery disease, and angiographic severity. No differences among types or dosages of beta-blockers were evident.
Beta-blockers may affect C-reactive protein concentrations. Randomized studies are required to confirm these findings.
C反应蛋白是冠状动脉疾病的一个重要危险因素，普伐他汀和阿司匹林治疗可降低血浆浓度。我们研究了用于治疗缺血性心脏病的其他心血管药物是否会影响C反应蛋白浓度。
采用高敏免疫比浊法测定333例接受诊断性血管造影的稳定型心绞痛且确诊为冠状动脉疾病的连续患者的血浆C反应蛋白浓度。
服用β受体阻滞剂的患者平均C反应蛋白浓度显著低于未服用者（低1.2mg/L，几何平均浓度相差40%；P<0.001）。在排除有β受体阻滞剂使用禁忌的患者，并对β受体阻滞剂治疗的可能性（倾向评分）和C反应蛋白浓度的其他临床预测因素（包括体重指数、高密度脂蛋白胆固醇水平、冠状动脉疾病家族史和血管造影严重程度）进行校正后，这种关联仍然显著（P = 0.03）。β受体阻滞剂的类型或剂量之间没有明显差异。
β受体阻滞剂可能会影响C反应蛋白浓度。需要进行随机研究来证实这些发现。
