Laboratório de Fisiopatologia Experimental, Universidade do Extremo Sul Catarinense, Criciúma, Santa Catarina, Brazil.
Inflammation. 2010 Aug;33(4):244-50. doi: 10.1007/s10753-009-9178-3.
The Framingham Risk Score (FRS) is widely recommended to estimate global risk for cardiovascular (CV) disease; however, it does not recognize all individuals with a high risk for coronary artery disease, because it does not take into account the various novel markers, such as the C-reactive protein levels (CRP). The present study aims to describe the profile of the simvastatin users and non-users in relation to FRS and high-sensitivity CRP (hs-CRP) levels.
In this cross-sectional study, 277 European descent individuals were divided in two groups: 177 using simvastatin 20 mg per day (T+) and 100 not using simvastatin (T-). TC, HDL-C, TG, glucose and hs-CRP levels were determined by standard methods and the FRS was calculated.
The individuals in T+ sample were more prevalent in high risk group (according FRS score) than individuals in T- sample (p < 0.0001; adjusted residual = 4.21). All the individuals, users and non-users, were simultaneously classified by FRS and hs-CRP levels and no significant differences were found, even though 21.6% of those individuals in T- showed high hs-CRP levels they were in the low CV risk group, as well as 9.9% of the simvastatin users.
Considering that some works have shown CRP as an independent risk factor of CV and that statins could reduce CRP levels and prevent CV events, our findings show that some people that might benefit from the pleiotropic effect of statin remain without treatment if the decision is based only in those classical risk factors present in FRS.
弗雷明汉风险评分（FRS）被广泛推荐用于估计心血管疾病（CV）的全球风险；然而，它并没有识别出所有具有高冠心病风险的个体，因为它没有考虑到各种新型标志物，如 C 反应蛋白水平（CRP）。本研究旨在描述与 FRS 和高敏 C 反应蛋白（hs-CRP）水平相关的辛伐他汀使用者和非使用者的特征。
在这项横断面研究中，将 277 名欧洲血统个体分为两组：177 名每天使用辛伐他汀 20mg（T+）和 100 名未使用辛伐他汀（T-）。通过标准方法测定 TC、HDL-C、TG、血糖和 hs-CRP 水平，并计算 FRS。
T+组个体的高危组（根据 FRS 评分）比 T-组个体更常见（p<0.0001；调整残差=4.21）。所有个体，无论是使用者还是非使用者，都同时根据 FRS 和 hs-CRP 水平进行分类，未发现显著差异，尽管 T-组中有 21.6%的个体 hs-CRP 水平较高，但他们处于低 CV 风险组，而辛伐他汀使用者中也有 9.9%的个体处于低 CV 风险组。
考虑到一些研究表明 CRP 是 CV 的独立危险因素，而他汀类药物可以降低 CRP 水平并预防 CV 事件，我们的研究结果表明，如果仅根据 FRS 中存在的那些经典危险因素做出决策，一些可能受益于他汀类药物的多效性作用的人可能会得不到治疗。
