C-reactive protein lowering with rosuvastatin in the METEOR study

Peters SAE, Palmer MK, Grobbee DE, Crouse JR III, O'Leary DH, Raichlen JS, Bots ML (Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Keele University, Keele, UK; Wake Forest University School of Medicine, Winston-Salem, NC, USA; Caritas Carney Hospital, Boston, MA, USA; AstraZeneca, Wilmington, DE, USA). C-reactive protein lowering with rosuvastatin in the METEOR study. J Intern Med 2010; 268: 155-161. Objectives. In addition to its LDL-C-lowering effects, statin treatment reduces the level of C-reactive protein (CRP). Long-term data on this effect in low-risk populations are limited. Furthermore, whether the CRP reduction is a consequence of LDL-C lowering or occurs independently remains unclear. We studied these aspects in the Measuring Effects on intima media Thickness: an Evaluation Of Rosuvastatin (METEOR) study, a randomized placebo-controlled trial amongst 984 low-risk subjects. Methods. METEOR is a randomized placebo-controlled trial that evaluated the effect of 40 mg of rosuvastatin on 2-year change in carotid intima media thickness (CIMT) amongst 984 low-risk patients (10-year Framingham risk < 10%) with modest CIMT (CIMT >= 1.2 and < 3.5 mm) and elevated LDL-C. CRP levels were measured at baseline and after 2 years of treatment. Results. Median baseline CRP was 1.4 mg L-1. Rosuvastatin lowered CRP significantly compared with placebo: -36% in the rosuvastatin group versus no change in the placebo group. There was no relation between change in CRP and change in LDL-C (Spearman correlation: 0.08; SE: 0.04). Stratified analyses showed that the CRP-lowering effect was present amongst all strata of baseline characteristics, including baseline lipids and CRP levels. However, the magnitude of CRP reduction was larger amongst women and participants older than 60 years. Conclusions. Rosuvastatin (40 mg) lowers CRP independently from its effects on LDL-C in low-risk subjects with normal baseline CRP levels and modest CIMT.