Rapid Effects of a Single High Dose of Simvastatin on C-Reactive Protein in Patients with Unstable Angina

Background: Elevated levels of C-reactive protein (CRP) became widely accepted as a risk factor for a higher incidence of coronary events, and rapid lowering of CRP following the administration of drugs may result in early beneficial effects on the coronary endothelium in patients with coronary heart disease, and reduce angina and coronary events after revascularization. Limited information has been available, however, on the potential effect of a single, high dose of simvastatin on CRP in patients with unstable angina (UA) within 48 h. Hypothesis: The present study was performed to investigate whether a rapid CRP reduction can be achieved by a single, high-dose simvastatin therapy in patients with UA given immediately on admission. Patients and Methods: Forty-two patients with chest pain at rest were randomly assigned to a single placebo dose or 80 mg of simvastatin given at the time of admission in addition to standard therapy. Blood samples were also drawn on admission and 48 h following admission for serum CRP evaluation. Results: The results showed that a single, high dose of 80 mg simvastatin induced significant reductions in median serum CRP levels and in mean CRP levels 48 h following the administration of simvastatin (25.4 and 32.7%, respectively; p < 0.001). Conclusions: Our data suggest that a single, high dose of simvastatin, given during admission, is an effective therapy for controlling inflammatory responses in patients with UA, and its beneficial effect on the vascular endothelium might be reflected by the immediate reduction in CRP levels in this high-risk subgroup, thus improving their prognosis.