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ASCOT-CRP (Anglo-Scandinavian CardiacOutcomes Trial—C-Reactive Protein)
ASCOT-CRP (Anglo-Scandinavian CardiacOutcomes Trial—C-Reactive Protein)PS Sever (Imperial College, London, UK)American Hea...
ASCOT-CRP: ResultsMeasuring hs-CRP had little to no utility in refining CV risk assessment beyondclassic risk factors• Bas...
ASCOT-CRP: Commentary*"It is clear that achievement of low LDL-cholesterol levels confers great benefit, andtheres no adde...
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ASCOT-CRP trial - Summary & Results

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http://www.theheart.org/web_slides/1185967.do

A post hoc analysis of the trial's lipid-lowering arm designed to evaluate the importance of high-sensitivity C-reactive protein (hs-CRP) in measuring CV risk

Published in: Health & Medicine, Sports
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Transcript of "ASCOT-CRP trial - Summary & Results"

  1. 1. ASCOT-CRP (Anglo-Scandinavian CardiacOutcomes Trial—C-Reactive Protein)
  2. 2. ASCOT-CRP (Anglo-Scandinavian CardiacOutcomes Trial—C-Reactive Protein)PS Sever (Imperial College, London, UK)American Heart Association 2010 Scientific Sessions• A post hoc analysis of the trials lipid-lowering arm designed to evaluate the importance of high-sensitivity C-reactive protein (hs-CRP) in measuring CV risk• Included 485 patients: Who reached the composite end point (CV death, nonfatal MI, coronary revascularization, or fatal/nonfatal stroke) Were age- and sex-matched to 1367 patients in the control group who hadnt suffered one of those events Were followed for 5.5 years
  3. 3. ASCOT-CRP: ResultsMeasuring hs-CRP had little to no utility in refining CV risk assessment beyondclassic risk factors• Baseline levels of hs-CRP and LDL-C were significantly correlated with each other (p<0.0001) and both were predictive of the composite CV end point: OR 1.31 (95% CI 1.10–1.56; p=0.002) for LDL-C OR 1.19 (95% CI 1.05–1.34; p=0.006) for every one–standard-deviation increase in hs-CRP• Lower on-treatment LDL-C but not hs-CRP was associated with a highly significant reduction in CV events over six months: LDL-C <2.1 mmol/L (median) vs LDL-C ≥ 2.1 mmol/L predicted a reduction in the composite end point (adjusted OR=0.41, 95% CI 0.22–0.75; p=0.004) hs-CRP <1.83 mg/L (median) vs hs-CRP ≥ 1.83 mg/L showed no such predictive effect (adjusted OR=0.86, 95% CI 0.49–1.51; p=0.60)
  4. 4. ASCOT-CRP: Commentary*"It is clear that achievement of low LDL-cholesterol levels confers great benefit, andtheres no added benefit by achieving a lower CRP level." - Dr Peter S Sever"Im not as convinced as Dr Sever that this damages the CRP hypothesis." - Dr Roger Blumenthal"Its a post hoc analysis of a previously published trial and we must take it with agrain of salt. It was a particularly high-risk primary-prevention cohort, and its fair tosay there were a relatively small number of events." - Dr Donald Lloyd Jones*All comments from ASCOT analysis fuels debate over JUPITER-based CRP indication for statins (http://www.theheart.org/article/1153661.do)
  5. 5. Become a member of http://www.theheart.org Become a fan on Facebook: http://www.facebook.com/theheartorg Follow us on Twitter: http://www.twitter.com/theheartorgtheheart.org is the leading online source of independent cardiology news.We are the top provider of news and opinions for over 100 000 physicians.
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