Effect of rosuvastatin on C-reactive protein and progression of aortic stenosis

Background Elevated C-reactive protein (CRP) is a common finding in patients with aortic stenosis (AS) and may be associated with rapid AS progression and worse outcome. The purpose of the study was to examine the role of high-sensitivity CRP and its interaction with rosuvastatin on the progression of AS. Methods We measured CRP at baseline, 1 year, and end of follow-up in 260 patients with a median follow-up of 3.5 years. Analyses were performed based on baseline CRP tertiles and baseline CRP >3 and <= 3 mg/L. Results After adjustment for baseline characteristics, higher CRP levels were associated with age, female gender, body mass index, and lower high-density lipoprotein cholesterol levels but not with AS severity. Treatment with rosuvastatin led to a persistent decrease in CRP at 1 year and end of follow-up. Progression of AS was detected in patients in all 3 CRP tertiles, and rosuvastatin treatment had no impact on progression in all 3 tertiles. Similar findings were observed using CRP >3 mg/L as the cutpoint. Multiple linear regression showed that baseline AS velocity (P < .001), but not CRP, was the only predictor of progression of AS; age (P = .05) and baseline AS velocity (P < .001), but not CRP and rosuvastatin treatment, were predictors of outcome events. Conclusion C-reactive protein does not predict severity, progression, and prognosis in patients with mild to moderate AS. Treatment with rosuvastatin reduces CRP levels but has no effect on the progression and clinical events of AS. (Am Heart J 2011;161:1133-9.)