RGD Reference Report - White blood cell count predicts reduction in coronary heart disease mortality with pravastatin. - Rat Genome Database

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White blood cell count predicts reduction in coronary heart disease mortality with pravastatin.

Authors: Stewart, RA  White, HD  Kirby, AC  Heritier, SR  Simes, RJ  Nestel, PJ  West, MJ  Colquhoun, DM  Tonkin, AM  Tonkin, Andrew M 
Citation: Stewart RA, etal., Circulation. 2005 Apr 12;111(14):1756-62. Epub 2005 Apr 4.
RGD ID: 5508474
Pubmed: PMID:15809366   (View Abstract at PubMed)
DOI: DOI:10.1161/01.CIR.0000160924.73417.26   (Journal Full-text)

BACKGROUND: Elevated serum inflammatory marker levels are associated with a greater long-term risk of cardiovascular events. Because 3-hydroxy-3-methylglutaryl coenzyme-A reductase inhibitors (statins) may have an antiinflammatory action, it has been suggested that patients with elevated inflammatory marker levels may have a greater reduction in cardiovascular risk with statin treatment. METHODS AND RESULTS: We evaluated the association between the white blood cell count (WBC) and coronary heart disease mortality during a mean follow-up of 6.0 years in the Long-Term Intervention With Pravastatin in Ischemic Disease (LIPID) Study, a clinical trial comparing pravastatin (40 mg/d) with a placebo in 9014 stable patients with previous myocardial infarction or unstable angina. An increase in baseline WBC was associated with greater coronary heart disease mortality in patients randomized to placebo (hazard ratio for 1x10(9)/L increase in WBC, 1.18; 95% CI, 1.12 to 1.25; P<0.001) but not pravastatin (hazard ratio, 1.02; 95% CI, 0.96 to 1.09; P=0.56; P for interaction=0.004). The numbers of coronary heart disease deaths prevented per 1000 patients treated with pravastatin were 0, 9, 30, and 38 for baseline WBC quartiles of <5.9, 6.0 to 6.9, 7.0 to 8.1, and >8.2x10(9)/L, respectively. WBC was a stronger predictor of this treatment benefit than the ratio of total to high-density lipoprotein cholesterol and a global measure of cardiac risk. There was also a greater reduction (P=0.052) in the combined incidence of cardiovascular mortality, nonfatal myocardial infarction, and stroke with pravastatin as baseline WBC increased (by quartile: 3, 41, 61, and 60 events prevented per 1000 patients treated, respectively). CONCLUSIONS: These data support the hypothesis that individuals with evidence of inflammation may obtain a greater benefit from statin therapy.

RGD Manual Disease Annotations    Click to see Annotation Detail View
TermQualifierEvidenceWithReferenceNotesSourceOriginal Reference(s)
Coronary Disease disease_progressionIMP 5508474 RGD 
Coronary Disease disease_progressionISOHMGCR (Homo sapiens)5508474; 5508474 RGD 

Objects Annotated

Genes (Rattus norvegicus)
Hmgcr  (3-hydroxy-3-methylglutaryl-CoA reductase)

Genes (Mus musculus)
Hmgcr  (3-hydroxy-3-methylglutaryl-Coenzyme A reductase)

Genes (Homo sapiens)
HMGCR  (3-hydroxy-3-methylglutaryl-CoA reductase)


Additional Information