Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials

LancetPublished Pooled analysis of three randomised trials

Authors' conclusion

Among patients receiving contemporary statins, inflammation assessed by high-sensitivity CRP was a stronger predictor for risk of future cardiovascular events and death than cholesterol assessed by LDLC.

Study context

Population
Patients with, or at high risk of, atherosclerotic disease receiving contemporary statins in PROMINENT, REDUCE-IT or STRENGTH
Participants
31,245 participants3 trials
Comparison
Highest vs lowest quartile of baseline high-sensitivity C-reactive protein (CRP) and of baseline LDL-C
Outcome
MACE, CV death and all-cause death by quartiles of baseline high-sensitivity CRP and LDL-C
Methodological detailscollaborative analysis, multinational
  • Collaborative analysis
  • Multinational

Pooled result

As reported in the abstract

Adjusted hazard ratio (95% CI)P value
Highest CRP quartile vs Lowest CRP quartileMACE
1.31(1.20–1.43)
P < 0.0001
Highest CRP quartile vs Lowest CRP quartileCV mortality
2.68(2.22–3.23)
P < 0.0001
Highest CRP quartile vs Lowest CRP quartileall-cause mortality
2.42(2.12–2.77)
P < 0.0001
Highest LDLC quartile vs Lowest LDLC quartileMACE
1.07(0.98–1.17)
P = 0.11
Highest LDLC quartile vs Lowest LDLC quartileCV death
1.27(1.07–1.50)
P = 0.0086
Highest LDLC quartile vs Lowest LDLC quartileall-cause death
1.16(1.03–1.32)
P = 0.025

Original publication

Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials. Lancet. Published 6 March 2023. doi:10.1016/s0140-6736(23)00215-5

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