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Inflammation, statin therapy, and risk of stroke after an acute coronary syndrome in the MIRACL study
Cardiovascular Division, Veterans Affairs Boston Healthcare System, West Roxbury, MA, United States, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States.
Cardiology Division, Veterans Affairs Medical Center, University of Colorado Health Sciences Center, Denver, CO, United States.
Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Endocrinology and Gastroenterology UHL.
Children's Hospital Boston, Harvard Medical School, Boston, MA, United States.
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2008 (English)In: Arteriosclerosis, Thrombosis and Vascular Biology, ISSN 1079-5642, E-ISSN 1524-4636, Vol. 28, no 1, 142-147 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE - Patients with acute coronary syndromes have an increased risk of stroke. We measured markers of inflammation in the MIRACL study, a randomized trial of atorvastatin versus placebo in acute coronary syndromes, to assess the relationship of inflammation to stroke. METHODS AND RESULTS - Baseline C-reactive protein (CRP), serum amyloid A (SAA), and interleukin-6 (IL-6) were collected in 2926 (95%) subjects. Baseline markers were related to stroke risk over the 16 weeks of the study. Subjects who subsequently experienced a stroke had higher CRP (27.5 versus 10.2 mg/L, P=0.0032), SAA (30.5 versus 16.0 mg/L, P=0.031), IL-6 (11 231 versus 6841 pg/L, P=0.004), and troponin (6.03 versus 3.19 ng/mL P=0.0032). The risk of stroke was related to greater CRP, SAA, and IL-6 in the placebo group only. Similarly, there was a graded increase in risk of stroke across quartiles of inflammatory markers in the placebo patients only. CONCLUSIONS - In acute coronary syndromes, the early risk of stroke relates to both heightened inflammation and size of myocardial necrosis. Treatment with atorvastatin abrogated the risk associated with elevated markers of inflammation in this study, a finding that provides a novel rationale for the use of statins in acute coronary syndromes. © 2008 American Heart Association, Inc.

Place, publisher, year, edition, pages
2008. Vol. 28, no 1, 142-147 p.
Keyword [en]
Acute coronary syndromes, CRP, Inflammation, Statin, Stroke
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-47333DOI: 10.1161/ATVBAHA.107.151787OAI: diva2:268229
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2012-01-06

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Olsson, Anders G.
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Internal MedicineFaculty of Health SciencesDepartment of Endocrinology and Gastroenterology UHL
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Arteriosclerosis, Thrombosis and Vascular Biology
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