The Effects of Statins on Cardiovascular and Inflammatory Biomarkers in Primary Prevention: A Systematic Review and Meta-Analysis
Open accessAbstract
BACKGROUND: Statins are well-established for their treatment of cardiovascular disease (CVD) due to their cholesterol-lowering effects and potential anti-inflammatory properties. Although previous systematic reviews demonstrate that statins reduce inflammatory biomarkers in the secondary prevention of CVD, none examine their effects on cardiac and inflammatory biomarkers in a primary prevention setting. METHODS: We conducted a systematic review and meta-analysis to examine the effects of statins on cardiovascular and inflammatory biomarkers among individuals without established CVD. The biomarkers included are: cardiac troponin, N-terminal pro B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), soluble vascular cell adhesion molecule (sVCAM), soluble intercellular adhesion molecule (sICAM), soluble E-selectin (sE-selectin) and endothelin-1 (ET-1). A literature search was performed through Ovid MEDLINE, Embase and CINAHL Plus for randomised controlled trials (RCTs) published up to June 2021. RESULTS: Overall, 35 RCTs with 26,521 participants were included in our meta-analysis. Data was pooled using random effects models presented as standardised mean differences (SMD) with 95% confidence intervals (CI). Combining 36 effect sizes from 29 RCTs, statin use resulted in a significant reduction in CRP levels (SMD -0.61; 95% CI -0.91, -0.32; P<0.001). This reduction was observed for both hydrophilic (SMD -0.39; 95% CI -0.62, -0.16; P<0.001) and lipophilic statins (SMD -0.65; 95% CI -1.01, -0.29; P<0.001). There were no significant changes in serum concentrations of cardiac troponin, NT-proBNP, TNF-α, IL-6, sVCAM, sICAM, sE-selectin and ET-1. CONCLUSION: This meta-analysis demonstrates that statin use reduces serum CRP levels in a primary prevention setting for CVD, with no clear effect on the other eight biomarkers studied.
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- Authors
- He, W. B., Ko, H. T. K., Curtis, A. J., Zoungas, S., Woods, R. L., Tonkin, A., Neumann, J. T., Turner, S. L., & Hopper, I.
- Affiliations
- The Alfred Hospital (AU)
- Monash University (AU)
- Corresponding author
- He, William B.
- ORCID
- Venue
- Heart, Lung and Circulation
- Publisher
- Elsevier BV
- Published
- 2023-08
- Volume
- 32
- Issue
- 8
- Pages
- 938-948
- ISSN
- 1443-9506 (ISSN-L)
- OpenAlex
- W4379801206
- Cited by
- 27
- References
- 37
- Citations by year
- 2026: 12 · 2025: 8 · 2024: 7
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Heart Lung and Circulation (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- statins, primary prevention, cardiovascular disease, inflammatory markers, C-reactive protein, cardiac troponin, NT-proBNP, TNF-α, interleukin-6, endothelial adhesion molecules, endothelin-1, lipophilic statins, hydrophilic statins
- MeSH terms
- Cardiovascular Diseases, Humans, Troponin, Tumor Necrosis Factor-alpha, Biomarkers, Interleukin-6, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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