Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H3412, Ottawa, ON K1Y 4W7 Canada.
Am Heart J. 2011 Jun;161(6):1133-9. doi: 10.1016/j.ahj.2011.03.016.
Elevated C-reactive protein (CRP) is a common finding in patients with aortic stenosis (AS) and may be associated with rapid AS progression and worse outcome. The purpose of the study was to examine the role of high-sensitivity CRP and its interaction with rosuvastatin on the progression of AS.
We measured CRP at baseline, 1 year, and end of follow-up in 260 patients with a median follow-up of 3.5 years. Analyses were performed based on baseline CRP tertiles and baseline CRP >3 and ≤3 mg/L.
After adjustment for baseline characteristics, higher CRP levels were associated with age, female gender, body mass index, and lower high-density lipoprotein cholesterol levels but not with AS severity. Treatment with rosuvastatin led to a persistent decrease in CRP at 1 year and end of follow-up. Progression of AS was detected in patients in all 3 CRP tertiles, and rosuvastatin treatment had no impact on progression in all 3 tertiles. Similar findings were observed using CRP >3 mg/L as the cutpoint. Multiple linear regression showed that baseline AS velocity (P < .001), but not CRP, was the only predictor of progression of AS; age (P = .05) and baseline AS velocity (P < .001), but not CRP and rosuvastatin treatment, were predictors of outcome events.
C-reactive protein does not predict severity, progression, and prognosis in patients with mild to moderate AS. Treatment with rosuvastatin reduces CRP levels but has no effect on the progression and clinical events of AS.
在主动脉瓣狭窄（AS）患者中，C 反应蛋白（CRP）升高是常见现象，可能与 AS 快速进展和预后不良相关。本研究旨在探讨高敏 CRP 及其与瑞舒伐他汀的相互作用在 AS 进展中的作用。
我们在 260 例患者中测量了基线、1 年和随访结束时的 CRP，中位随访时间为 3.5 年。分析基于基线 CRP 三分位数和基线 CRP >3 和≤3mg/L 进行。
在校正基线特征后，较高的 CRP 水平与年龄、女性、体重指数和较低的高密度脂蛋白胆固醇水平相关，但与 AS 严重程度无关。瑞舒伐他汀治疗可使 CRP 在 1 年和随访结束时持续下降。所有 3 个 CRP 三分位数的患者均检测到 AS 进展，瑞舒伐他汀治疗对所有 3 个三分位数的进展均无影响。使用 CRP >3mg/L 作为切点也观察到了类似的发现。多元线性回归显示，基线 AS 速度（P<0.001）是 AS 进展的唯一预测因子，而 CRP 不是；年龄（P=0.05）和基线 AS 速度（P<0.001）是预测结局事件的因素，但 CRP 和瑞舒伐他汀治疗不是。
CRP 不能预测轻度至中度 AS 患者的严重程度、进展和预后。瑞舒伐他汀治疗可降低 CRP 水平，但对 AS 的进展和临床事件无影响。
