Statin User’s CVD Risk Tied Stronger with Inflammation Than Residual Cholesterol

A collaborative analysis of 3 multinational trials suggested that inflammatory risk was a stronger predictor of cardiovascular disease (CVD) events, CVD death, and all-cause death than residual cholesterol risk in statin users. The analysis included 31245 statin users with/or at high risk of atherosclerotic disease. The observed ranges for baseline high-sensitivity C-reactive protein (CRP) and low-density lipoprotein cholesterol (LDLC), and the relationships of each biomarker to subsequent CVD event rates, were almost identical in the 3 trials. The inflammatory biomarker was significantly associated with incident major adverse CVD events (highest high-sensitivity CRP quartile vs lowest high-sensitivity CRP quartile, adjusted HR 1·31), CVD mortality (HR 2·68), and all-cause mortality (HR 2·42). By contrast, the relationship of residual cholesterol risk was almost neutral for major adverse CVD events (highest LDLC quartile vs lowest LDLC quartile, adjusted HR 1·07), and of low magnitude for CVD death (HR 1·27) and all-cause death (HR 1·16). These findings have implications for the selection of adjunctive treatments beyond statin therapy and suggest that combined use of lipid-lowering and inflammation-inhibiting therapies might be needed to further reduce CVD risk. Inflammation and hyperlipidemia contribute with similar magnitude to CVD risks in people not receiving statins. Source: https://www.thelancet.com/