NEW YORK (Reuters Health) Mar 26 - C reactive protein (CRP) levels are lowered to a greater extent with simvastatin alone after acute MI (AMI) than when metoprolol or propranolol is added, indicating that the beta blockers attenuate the anti-inflammatory effect of the statin.
Those findings come from the Brasilia Heart Study, published in the February 15 issue of the American Journal of Cardiology.
Dr. Andrei C. Sposito and colleagues at the University of Brasilia Medical School, Brazil, divided 189 patients with AMI into those given simvastatin alone, those on metoprolol or propranolol, those given simvastatin plus either metoprolol or propranolol, or patients given neither. The researchers evaluated the effects of the four regimens on CRP levels on days 1 and 5 after AMI.
Baseline median CRP level was 0.4 mg/dL in the simvastatin group and between 0.5 and 0.6 mg/dL in the other three groups.
By day 5, median CRP was 1.3 mg/dL in the simvastatin group, 4.3 mg/dL in the beta-blocker group, 4.6 mg/dl in the beta- blocker plus statin group, and 4.4 mg/dL in patients who received neither.
The difference in CRP between days 1 and 5 was significantly lower in the simvastatin group compared with levels in any of the other three cohorts, who all had similar CRP levels. The significance remained after adjustment for age, gender, and baseline CRP.
"In line with our previous study with atorvastatin, we found that simvastatin treatment attenuated the intense increase in systemic inflammatory activity during the acute phase of MI," Dr. Sposito and colleagues write. "In addition, for the first time, this study indicated that such an anti-inflammatory effect of statins could be attenuated by concomitant treatment with propranolol or metoprolol."
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