thrombosis and thromboembolism phần 2

những người tham gia học tập với mức độ thấp LDL cholesterol người đã ở trên mức trung bình của CRP. Cụ thể, mức độ giảm nguy cơ kết hợp với sử dụng statin cho những người có mức CRP trung bình trên nhưng mức độ lipid bình thường gần giống | Inflammation and Arterial Thrombosis 21 dian LDL value in AFCAPS TexCAPS such patients had a number-to-needed-to-treat of 42 a level considered not only cost-effective but cost-saving. However lovastatin therapy was also effective in reducing the risk of first-ever coronary events among study participants with low levels of LDL cholesterol who had above-average levels of CRP. Specifically the magnitude of risk reduction associated with statin use for those with above-average CRP levels but normal lipid levels was almost identical to that observed among those with above-median cholesterol levels. Moreover among such patients who had elevated levels of CRP but normal lipid levels the event rate was just as high as that observed among those with overt hyperlipidemia. For these individuals the number-needed-to-treat was also very low NNT 48 . By contrast lovastatin appeared to have no effect in participants in AFCAPS TexCAPS who had below-average LDL levels and below-average CRP levels. As might be expected the absolute event rate was very low in this group who had normal to low lipid levels and no evidence of inflammation. In this low-risk population defined by both LDL and CRP the NNT was exceptionally large and statin utility cost-ineffective. Finally like the PRINCE study the AFCAPS TexCAPS CRP substudy showed that lovastatin reduced CRP levels in a lipid-independent manner this time at 1year follow-up. When viewed together data from the PRINCE study 196 and the AFCAPS TexCAPS CRP substudy 200 confirm that elevated levels of CRP are a potent independent predictor of heart attack and stroke and that combining CRP with cholesterol levels provides an improved tool for global risk prediction. Moreover both of these large studies demonstrate clearly that statin therapy leads to approximately 15 reductions in CRP levels. Last although hypothesis-generating the AFCAPS TexCAPS CRP substudy also suggests that statins may significantly reduce vascular risk even in .

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48    4    1    30-07-2021