Reduction in high-sensitivity C-reactive protein levels in patients with ischemic stroke by statin Treatment: Hs-CRP Sub-Study in J-STARS

Aims: the pleiotropic effects of statins on recurrent stroke remain unclear. we investigated the effects of pravastatin on high-sensitivity c-reactive proteins (hs-crp) in ischemic stroke,and explored the impact of hs-crp on recurrent stroke and vascular events. methods: this randomized open-label trial was ancillary to the j-stars trial. one thousand and ninety-five patients with non-cardiogenic ischemic stroke were assigned to the pravastatin (n=545) or control groups (n=550). the primary and secondary endpoints were serum hs-crp reduction and stroke recurrence,including both ischemic and hemorrhagic ones,respectively. onset of vascular events and each stroke subtype in relation to hs-crp levels were also determined. results: in the pravastatin treatment group,hs-crp levels (median 711 μg/l,iqr 344–1500) significantly decreased 2 months later (median 592 μg/l,iqr 301–390),and they remained significantly lower until the end of the study. however,in the control group,baseline hs-crp levels were similar to those 2 months later. the reduction of hs-crp levels from the baseline to 2 months in the pravastatin group was statistically significant compared with the control (p=0.007). one sd increase in log-transformed hs-crp increased the risk of stroke recurrence (hr 1.17,95% ci 0.97 −1.40) and vascular events (hr 1.30,95% ci 1.12 −1.51). with an hs-crp cut-off of 1000