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Effect of Beta Blockers (Metoprolol or Propranolol) on Effect of Simvastatin in Lowering C-Reactive Protein in Acute Myocardial Infarction

Recent data indicated that statin therapy may fail to reduce the incidence of coronary events in patients concomitantly using β blockers. The aim of the present study was to examine whether the concomitant use of β blockers would modify the anti-inflammatory action of statins. Changes in C-reactive... Full description

Journal Title: The American journal of cardiology 2009, Vol.103 (4), p.461-463
Main Author: Quinaglia e Silva, Jose C., MD
Other Authors: Munhoz, Daniel B , Morato, Tiago N , Gurgel, Augusto , Macedo, Antonio C.T , Sever, Peter, MD, PhD , Sposito, Andrei C., MD, PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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title: Effect of Beta Blockers (Metoprolol or Propranolol) on Effect of Simvastatin in Lowering C-Reactive Protein in Acute Myocardial Infarction
format: Article
creator:
  • Quinaglia e Silva, Jose C., MD
  • Munhoz, Daniel B
  • Morato, Tiago N
  • Gurgel, Augusto
  • Macedo, Antonio C.T
  • Sever, Peter, MD, PhD
  • Sposito, Andrei C., MD, PhD
subjects:
  • Abridged Index Medicus
  • Adrenergic beta-Antagonists - pharmacology
  • Adrenergic beta-Antagonists - therapeutic use
  • Aged
  • Beta blockers
  • Biological and medical sciences
  • C-reactive protein
  • C-Reactive Protein - analysis
  • Cardiac patients
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular
  • Cohort Studies
  • Coronary heart disease
  • Drug therapy
  • Drug Therapy, Combination
  • Effectiveness studies
  • Female
  • Heart
  • Heart attack
  • Heart attacks
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
  • Male
  • Medical sciences
  • Metoprolol
  • Metoprolol - pharmacology
  • Metoprolol - therapeutic use
  • Middle Aged
  • Myocardial Infarction - blood
  • Myocardial Infarction - drug therapy
  • Myocarditis. Cardiomyopathies
  • Propranolol - pharmacology
  • Propranolol - therapeutic use
  • Propranolol hydrochloride
  • Simvastatin
  • Simvastatin - pharmacology
  • Simvastatin - therapeutic use
  • Statins
  • Treatment Outcome
ispartof: The American journal of cardiology, 2009, Vol.103 (4), p.461-463
description: Recent data indicated that statin therapy may fail to reduce the incidence of coronary events in patients concomitantly using β blockers. The aim of the present study was to examine whether the concomitant use of β blockers would modify the anti-inflammatory action of statins. Changes in C-reactive protein (CRP) between days 1 and 5 after myocardial infarction were evaluated in 189 patients treated with simvastatin alone (S), β blockers alone (B; propranolol or metoprolol), S + B, or neither of these 2 medications (N) in a prospective observational cohort. At baseline, median CRP was lower in the S group (0.40 mg/dl, interquartile range 0.1 to 0.6) than the other groups (B: 0.6 mg/dl, interquartile range 0.4 to 1.6; S + B: 0.5 mg/dl, interquartile range 0.3 to 1.2; and N: 0.6 mg/dl, interquartile range 0.2 to 1.5). By day 5, median CRP was 1.3 mg/dl (interquartile range 0.7 to 2.6), 4.3 (interquartile range 1.6 to 8.8), 4.6 (interquartile range 2.8 to 9.5), and 4.4 (interquartile range 1.9 to 9.9) for the S, B, S + B, and N groups, respectively. After adjusting for loge baseline CRP, the difference in loge CRP between days 1 and 5 was significantly lower in the S group compared with the B (−0.74 ± 0.23 [SE], p = 0.001) or S + B group (−0.99 ± 0.20 [SE], p
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleEffect of Beta Blockers (Metoprolol or Propranolol) on Effect of Simvastatin in Lowering C-Reactive Protein in Acute Myocardial Infarction
creatorQuinaglia e Silva, Jose C., MD ; Munhoz, Daniel B ; Morato, Tiago N ; Gurgel, Augusto ; Macedo, Antonio C.T ; Sever, Peter, MD, PhD ; Sposito, Andrei C., MD, PhD
creatorcontribQuinaglia e Silva, Jose C., MD ; Munhoz, Daniel B ; Morato, Tiago N ; Gurgel, Augusto ; Macedo, Antonio C.T ; Sever, Peter, MD, PhD ; Sposito, Andrei C., MD, PhD ; Brasilia Heart Study Group
descriptionRecent data indicated that statin therapy may fail to reduce the incidence of coronary events in patients concomitantly using β blockers. The aim of the present study was to examine whether the concomitant use of β blockers would modify the anti-inflammatory action of statins. Changes in C-reactive protein (CRP) between days 1 and 5 after myocardial infarction were evaluated in 189 patients treated with simvastatin alone (S), β blockers alone (B; propranolol or metoprolol), S + B, or neither of these 2 medications (N) in a prospective observational cohort. At baseline, median CRP was lower in the S group (0.40 mg/dl, interquartile range 0.1 to 0.6) than the other groups (B: 0.6 mg/dl, interquartile range 0.4 to 1.6; S + B: 0.5 mg/dl, interquartile range 0.3 to 1.2; and N: 0.6 mg/dl, interquartile range 0.2 to 1.5). By day 5, median CRP was 1.3 mg/dl (interquartile range 0.7 to 2.6), 4.3 (interquartile range 1.6 to 8.8), 4.6 (interquartile range 2.8 to 9.5), and 4.4 (interquartile range 1.9 to 9.9) for the S, B, S + B, and N groups, respectively. After adjusting for loge baseline CRP, the difference in loge CRP between days 1 and 5 was significantly lower in the S group compared with the B (−0.74 ± 0.23 [SE], p = 0.001) or S + B group (−0.99 ± 0.20 [SE], p <0.0001). The significance remained after adjustment for age, gender, and baseline CRP. There was no significant difference in change in CRP between the SB and B groups. In conclusion, the present study confirmed the anti-inflammatory action of statins and showed that concomitant use of β blockers may significantly attenuate this effect.
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languageeng
publisherNew York, NY: Elsevier Inc
subjectAbridged Index Medicus ; Adrenergic beta-Antagonists - pharmacology ; Adrenergic beta-Antagonists - therapeutic use ; Aged ; Beta blockers ; Biological and medical sciences ; C-reactive protein ; C-Reactive Protein - analysis ; Cardiac patients ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cohort Studies ; Coronary heart disease ; Drug therapy ; Drug Therapy, Combination ; Effectiveness studies ; Female ; Heart ; Heart attack ; Heart attacks ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Male ; Medical sciences ; Metoprolol ; Metoprolol - pharmacology ; Metoprolol - therapeutic use ; Middle Aged ; Myocardial Infarction - blood ; Myocardial Infarction - drug therapy ; Myocarditis. Cardiomyopathies ; Propranolol - pharmacology ; Propranolol - therapeutic use ; Propranolol hydrochloride ; Simvastatin ; Simvastatin - pharmacology ; Simvastatin - therapeutic use ; Statins ; Treatment Outcome
ispartofThe American journal of cardiology, 2009, Vol.103 (4), p.461-463
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1Munhoz, Daniel B
2Morato, Tiago N
3Gurgel, Augusto
4Macedo, Antonio C.T
5Sever, Peter, MD, PhD
6Sposito, Andrei C., MD, PhD
7Brasilia Heart Study Group
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0Effect of Beta Blockers (Metoprolol or Propranolol) on Effect of Simvastatin in Lowering C-Reactive Protein in Acute Myocardial Infarction
1The American journal of cardiology
addtitleAm J Cardiol
descriptionRecent data indicated that statin therapy may fail to reduce the incidence of coronary events in patients concomitantly using β blockers. The aim of the present study was to examine whether the concomitant use of β blockers would modify the anti-inflammatory action of statins. Changes in C-reactive protein (CRP) between days 1 and 5 after myocardial infarction were evaluated in 189 patients treated with simvastatin alone (S), β blockers alone (B; propranolol or metoprolol), S + B, or neither of these 2 medications (N) in a prospective observational cohort. At baseline, median CRP was lower in the S group (0.40 mg/dl, interquartile range 0.1 to 0.6) than the other groups (B: 0.6 mg/dl, interquartile range 0.4 to 1.6; S + B: 0.5 mg/dl, interquartile range 0.3 to 1.2; and N: 0.6 mg/dl, interquartile range 0.2 to 1.5). By day 5, median CRP was 1.3 mg/dl (interquartile range 0.7 to 2.6), 4.3 (interquartile range 1.6 to 8.8), 4.6 (interquartile range 2.8 to 9.5), and 4.4 (interquartile range 1.9 to 9.9) for the S, B, S + B, and N groups, respectively. After adjusting for loge baseline CRP, the difference in loge CRP between days 1 and 5 was significantly lower in the S group compared with the B (−0.74 ± 0.23 [SE], p = 0.001) or S + B group (−0.99 ± 0.20 [SE], p <0.0001). The significance remained after adjustment for age, gender, and baseline CRP. There was no significant difference in change in CRP between the SB and B groups. In conclusion, the present study confirmed the anti-inflammatory action of statins and showed that concomitant use of β blockers may significantly attenuate this effect.
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0Abridged Index Medicus
1Adrenergic beta-Antagonists - pharmacology
2Adrenergic beta-Antagonists - therapeutic use
3Aged
4Beta blockers
5Biological and medical sciences
6C-reactive protein
7C-Reactive Protein - analysis
8Cardiac patients
9Cardiology
10Cardiology. Vascular system
11Cardiovascular
12Cohort Studies
13Coronary heart disease
14Drug therapy
15Drug Therapy, Combination
16Effectiveness studies
17Female
18Heart
19Heart attack
20Heart attacks
21Humans
22Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
23Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
24Male
25Medical sciences
26Metoprolol
27Metoprolol - pharmacology
28Metoprolol - therapeutic use
29Middle Aged
30Myocardial Infarction - blood
31Myocardial Infarction - drug therapy
32Myocarditis. Cardiomyopathies
33Propranolol - pharmacology
34Propranolol - therapeutic use
35Propranolol hydrochloride
36Simvastatin
37Simvastatin - pharmacology
38Simvastatin - therapeutic use
39Statins
40Treatment Outcome
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titleEffect of Beta Blockers (Metoprolol or Propranolol) on Effect of Simvastatin in Lowering C-Reactive Protein in Acute Myocardial Infarction
authorQuinaglia e Silva, Jose C., MD ; Munhoz, Daniel B ; Morato, Tiago N ; Gurgel, Augusto ; Macedo, Antonio C.T ; Sever, Peter, MD, PhD ; Sposito, Andrei C., MD, PhD
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1Adrenergic beta-Antagonists - pharmacology
2Adrenergic beta-Antagonists - therapeutic use
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4Beta blockers
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6C-reactive protein
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8Cardiac patients
9Cardiology
10Cardiology. Vascular system
11Cardiovascular
12Cohort Studies
13Coronary heart disease
14Drug therapy
15Drug Therapy, Combination
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17Female
18Heart
19Heart attack
20Heart attacks
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40Treatment Outcome
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abstractRecent data indicated that statin therapy may fail to reduce the incidence of coronary events in patients concomitantly using β blockers. The aim of the present study was to examine whether the concomitant use of β blockers would modify the anti-inflammatory action of statins. Changes in C-reactive protein (CRP) between days 1 and 5 after myocardial infarction were evaluated in 189 patients treated with simvastatin alone (S), β blockers alone (B; propranolol or metoprolol), S + B, or neither of these 2 medications (N) in a prospective observational cohort. At baseline, median CRP was lower in the S group (0.40 mg/dl, interquartile range 0.1 to 0.6) than the other groups (B: 0.6 mg/dl, interquartile range 0.4 to 1.6; S + B: 0.5 mg/dl, interquartile range 0.3 to 1.2; and N: 0.6 mg/dl, interquartile range 0.2 to 1.5). By day 5, median CRP was 1.3 mg/dl (interquartile range 0.7 to 2.6), 4.3 (interquartile range 1.6 to 8.8), 4.6 (interquartile range 2.8 to 9.5), and 4.4 (interquartile range 1.9 to 9.9) for the S, B, S + B, and N groups, respectively. After adjusting for loge baseline CRP, the difference in loge CRP between days 1 and 5 was significantly lower in the S group compared with the B (−0.74 ± 0.23 [SE], p = 0.001) or S + B group (−0.99 ± 0.20 [SE], p <0.0001). The significance remained after adjustment for age, gender, and baseline CRP. There was no significant difference in change in CRP between the SB and B groups. In conclusion, the present study confirmed the anti-inflammatory action of statins and showed that concomitant use of β blockers may significantly attenuate this effect.
copNew York, NY
pubElsevier Inc
pmid19195502
doi10.1016/j.amjcard.2008.10.007