{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:26:14Z","timestamp":1782311174262,"version":"3.54.5"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,8,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Several lipid\u2010lowering therapies reduce CRP (C\u2010reactive protein) independently of LDL\u2010C (low\u2010density lipoprotein cholesterol) reduction, but the association between\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              parameters and benefits from more\u2010intensive\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C lowering is inconclusive. We aimed to determine whether the benefits of more\u2010 versus less\u2010intensive\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C lowering on cardiovascular events related to baseline, achieved, or magnitude of reduction in\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              concentrations.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              PubMed,\n              <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n              , and Cochrane were searched through July 2, 2018. We included randomized controlled cardiovascular outcome trials of\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C lowering with statins or ezetimibe. Two reviewers independently extracted study data and rated study quality. Data were analyzed using meta\u2010analysis and metaregression analysis. Rate ratios of mortality and cardiovascular outcomes associated with baseline, achieved, and magnitude reduction of\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              concentration were calculated. Twenty\u2010four trials were included, with 171\u00a0250 patients randomly assigned to more\u2010 or less\u2010intensive\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C\u2013lowering treatments. Median follow\u2010up duration was 4.2\u00a0years. More\u2010intensive\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C lowering resulted in a significant reduction in incidences of all outcomes. Compared with less\u2010intensive\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C lowering, more\u2010intensive\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C lowering was associated with less reductions in myocardial infarction with a higher baseline\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              concentration (change in rate ratios per 1\u2010mg\/L increase in log\u2010transformed\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              , 1.12 [95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.04\u20131.22;\n              <jats:italic>P<\/jats:italic>\n              =0.007]), but not other outcomes. Similar risk reductions occurred for more\u2010 versus less\u2010intensive\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C\u2013lowering therapy regardless of the magnitude of\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              reduction or the achieved\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              level for all outcomes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Baseline\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              concentrations might be associated with the benefits of\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010C lowering on myocardial infarction, but\u00a0no other outcomes, whereas the achieved and magnitude of reduction in\n              <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>\n              did not seem to have an important association.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.012428","type":"journal-article","created":{"date-parts":[[2019,8,14]],"date-time":"2019-08-14T09:10:09Z","timestamp":1565773809000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Association Between Baseline, Achieved, and Reduction of CRP and Cardiovascular Outcomes After LDL Cholesterol Lowering with Statins or Ezetimibe: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"8","author":[{"given":"Xin\u2010Lin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong\u2010Fang","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010Wen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Na","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Affiliated Drum Tower Hospital Nanjing University School of Medicine Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61350-5"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615664"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410489"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1707914"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61717-7"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.15.1933"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200106283442601"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.643114"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62174-5"},{"key":"e_1_3_1_11_2","unstructured":"Higgins JPT Altman DG Sterne JAC. 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