Objective To determine the effectiveness of statins in reducing C-reactive protein in patients with cerebral infarction and the potency of C-reactive protein as an indicator for preventing cerebrovascular events.
Methods We searched PubMed, EMbase, Central Register of Controlled Trials, CBMdisc and CNKI from the date of establishment through August 2008. Bibliographies of the retrieved articles were also checked. Data was extracted and evaluated by two reviewers independently with a designed extraction form. The RevMan 5.0 software was used to carry out meta-analysis.
Results Twenty-three randomized trials involving 1946 patients were included. The results of meta-analyses showed the following: statins reduced C-reactive protein compared to the control group (WMD= –5.79, 95%CI –7.32 to –4.26); statins were associated with a reduction of carotid intima-media thickness (IMT) (WMD= –0.21, 95%CI –0.25 to –0.17); atorvastatin greatly reduced C-reactive protein than the simvastatin control group (WMD= –1.78, 95%CI –3.92 to 0.36); statins were associated with a slight improvement in neurological deficit (OR= 2.22, 95%CI 0.94 to 5.21).
Conclusion The evidence currently available shows that statins can reduce C-reactive protein and carotid IMT in the patients with cerebral infarction compared to the control group. However, it is not clear whether statins reducing C-reactive protein is correlated to the improvement of neurological deficit and prognosis. Similar trials in future should focus on the relationship between the change of C-reactive protein and clinical outcomes.
Citation: HE Zhongfang,LIU Fang,ZHAI Suodi,WU Xinan,WANG Ting,LIANG Li. Statins Therapy for C-reactive Protein and Carotid Intima-Media Thickness in Patients with Cerebral Infarction: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2009, 09(8): 873-879. doi: 10.7507/1672-2531.20090154 Copy