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Department of Family Medicine, Clalit Health Services, Central District Rehobot.

C-Reactive protein levels are elevated in most patients with unstable angina despite concomitant statin therapy. Roberto Ainbinder (1), Marina Somin (2), Nick Beilinson (2), Sorel Goland (2), Stephen Malnick (2). Department of Family Medicine, Clalit Health Services, Central District Rehobot.

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Department of Family Medicine, Clalit Health Services, Central District Rehobot.

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  1. C-Reactive protein levels are elevated in most patients with unstable angina despite concomitant statin therapy. Roberto Ainbinder (1), Marina Somin (2), Nick Beilinson (2), Sorel Goland (2), Stephen Malnick (2). • Department of Family Medicine, Clalit Health Services, Central District Rehobot. • Internal Medicine "C" Kaplan Medical Center Rehobot.

  2. Introduction • Atherosclerosis, is an inflammatory element in addition to a strong link to elevated cholesterol. • Statin lower CRP levels independent of their effect on cholesterol. • Statin therapy have good clinical benefit when levels of CRP are elevated. • Study of patients with ACS, CRP less than 2 mg/dL, good clinical outcomes, independently of the effect on serum LDL cholesterol.

  3. Methods • Cohort of patients admitted to I.M. with UA. • To determine: 1- recommended levels of LDL- cholesterol. 2- CRP level in these patients. • Exclusion criteria: 1- Concomitant infection. 2- Fever. 3- Rheumatological disease. 4- Steroids therapy in last 2 weeks. • Details were taken: statin use, dose, other medications, medical diseases, LDL, CRP. • Comparison between groups was performed with a p<0.05 considered as significant.

  4. Results

  5. Results • Only 9 of 26 patients whit statin therapy had LDL greater than 100 mg/dL. • 15 of the 23 patients not receiving statins had LDL greater than 100 mg/dL. • Only 8 of 49 patients (16%) had a LDL less than 70 mg/dL. • Only 3 of 49 patients had both a LDL less than 70 mg/dL and a CRP less than 2 mg/dL.

  6. The levels of CRP and LDL cholesterol are shown, stratified by thosereceiving and those not receiving statin therapy. The decrease in LDLcholesterol in those patients receiving statin is significant, p= 0.035. Results

  7. Discussion • The majority of patients with UA the LDL-cholesterol levels do not have in recommended limits. • The majority of the patients with UA have a CRP level greater than 2 mg/dL. • No difference in the level of CRP between patients who did or did not receive statins in admission.

  8. Discussion • 56% of patients admitted take statin at admission. • 35% had LDL levels that were not within the recommended guidelines. • Only 12.2% patients had both LDL and CRP levels within published guidelines limits. • Only 6.1%, had both a LDL less than 70 mg/dL and a CRP less than 2 mg/dL.

  9. Discussion • Our initial study be followed by study that determines CRP after hospital discharge. • Difficult to interpret since many patients adjusted dose, undergo invasive coronary procedures which will influence CRP. • Despite the universal access to statin therapy in Israel, the vast majority of patients are under treated.

  10. Thank you

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