CC BY-NC-ND 4.0 · J Lab Physicians 2023; 15(04): 498-502
DOI: 10.1055/s-0043-1768167
Original Article

Effect of Statins on the Inflammatory Markers in Patients with Coronary Artery Disease

Sujatha Mahadevarao Premnath
1   Department of Biochemistry, Pondicherry Institute of Medical Science, Pondicherry, India
Sunil Kumar Nanda
1   Department of Biochemistry, Pondicherry Institute of Medical Science, Pondicherry, India
Lopamudra Ray
2   Department of Biochemistry, CCM Government Medical College, Durg, Chhattisgarh, India
Mark Chirstopher Arokiaraj
3   Department of Cardiology, Pondicherry Institute of Medical Science, Pondicherry, India
› Author Affiliations


Introduction Atherosclerosis mediated by inflammatory markers is the corner stone in the pathology of coronary artery disease (CAD). Hyperlipidemia, one of the risk factors is treated with statins. Statins also have a pleotropic role in reducing inflammation. Effect of statins on two inflammatory markers pentraxin 3(PTX 3) and high sensitivity C-reactive protein (hs-CRP) is explored in this study.

Objective This article estimates the levels of serum PTX 3 and hs-CRP in CAD patients with and without statin therapy and correlates the levels with low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) in CAD patients without statin therapy.

Material and Methods This was a cross-sectional study conducted on 62 patients with CAD diagnosed by coronary angiogram. They were divided into two groups. Group I were the CAD patients on statin therapy and group II were CAD patients who never had any lipid lowering drugs irrespective of their lipid values. Serum PTX3, hs-CRP, and lipid profile were estimated in these groups. Comparison between the groups was done using Student's t-test and correlation analyzed using Pearson's correlation.

Results Serum PTX 3 and hs-CRP levels were higher than the reference range in both the groups. But group I showed significantly low PTX 3 levels (p-value = 0.032) compared with group II. There was a significant positive relationship between PTX 3 and LDL-c (p = 0.003) in group II.

Conclusion CAD patients on statin therapy have lower vessel wall inflammation compared with patients without statin therapy.

Publication History

Received: 01 December 2022

Accepted: 06 February 2023

Article published online:
18 April 2023

© 2023. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Roth GA, Mensah GA, Johnson CO. et al; GBD-NHLBI-JACC Global Burden of Cardiovascular Diseases Writing Group. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 Study. J Am Coll Cardiol 2020; 76 (25) 2982-3021
  • 2 Sreeniwas Kumar A, Sinha N. Cardiovascular disease in India: a 360 degree overview. Med J Armed Forces India 2020; 76 (01) 1-3
  • 3 Prabhakaran D, Jeemon P, Roy A. Cardiovascular diseases in India. Circulation 2016; 133 (16) 1605-1620
  • 4 Madjid M, Willerson JT. Inflammatory markers in coronary heart disease. Br Med Bull 2011; 100 (01) 23-38
  • 5 Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002; 105 (09) 1135-1143
  • 6 Hackam DG, Shumak SL. C-reactive protein for the prediction of cardiovascular risk: ready for prime-time?. CMAJ 2004; 170 (10) 1563-1565
  • 7 Inoue K, Kodama T, Daida H. Pentraxin 3: a novel biomarker for inflammatory cardiovascular disease. Int J Vasc Med 2012; 2012: 657025
  • 8 Ristagno G, Fumagalli F, Bottazzi B. et al. Pentraxin 3 in cardiovascular disease. Front Immunol 2019; 10: 823
  • 9 Fornai F, Carrizzo A, Forte M. et al. The inflammatory protein Pentraxin 3 in cardiovascular disease. Immun Ageing 2016; 13 (01) 25
  • 10 Diamantis E, Kyriakos G, Quiles-Sanchez LV, Farmaki P, Troupis T. The anti-inflammatory effects of statins on coronary artery disease: an updated review of the literature. Curr Cardiol Rev 2017; 13 (03) 209-216
  • 11 Proute MC, Kothur N, Georgiou P. et al. The effect of statin therapy on inflammatory biomarkers: a systematic review. Cureus 2021; 13 (09) e18273
  • 12 Ridker PM, Cannon CP, Morrow D. et al; Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) Investigators. C-reactive protein levels and outcomes after statin therapy. N Engl J Med 2005; 352 (01) 20-28
  • 13 Yamasaki K, Kurimura M, Kasai T, Sagara M, Kodama T, Inoue K. Determination of physiological plasma pentraxin 3 (PTX3) levels in healthy populations. Clin Chem Lab Med 2009; 47 (04) 471-477
  • 14 Kamath DY, Xavier D, Sigamani A, Pais P. High sensitivity C-reactive protein (hsCRP) & cardiovascular disease: an Indian perspective. Indian J Med Res 2015; 142 (03) 261-268
  • 15 Cai T, Abel L, Langford O. et al. Associations between statins and adverse events in primary prevention of cardiovascular disease: systematic review with pairwise, network, and dose-response meta-analyses. BMJ 2021; 374: n1537
  • 16 Rolph MS, Zimmer S, Bottazzi B, Garlanda C, Mantovani A, Hansson GK. Production of the long pentraxin PTX3 in advanced atherosclerotic plaques. Arterioscler Thromb Vasc Biol 2002; 22 (05) e10-e14
  • 17 Liu H, Guan S, Fang W, Yuan F, Zhang M, Qu X. Associations between pentraxin 3 and severity of coronary artery disease. BMJ Open 2015; 5 (04) e007123
  • 18 Nerkiz P, Doganer YC, Aydogan U. et al. Serum pentraxin-3 level in patients who underwent coronary angiography and relationship with coronary atherosclerosis. Med Princ Pract 2015; 24 (04) 369-375
  • 19 Ray KK, Cannon CP. The potential relevance of the multiple lipid-independent (pleiotropic) effects of statins in the management of acute coronary syndromes. J Am Coll Cardiol 2005; 46 (08) 1425-1433
  • 20 Sindhu S, Singh HK, Salman MT, Fatima J, Verma VK. Effects of atorvastatin and rosuvastatin on high-sensitivity C-reactive protein and lipid profile in obese type 2 diabetes mellitus patients. J Pharmacol Pharmacother 2011; 2 (04) 261-265
  • 21 Yoon SS, Dillon CF, Carroll M, Illoh K, Ostchega Y. Effects of statins on serum inflammatory markers: the U.S. National Health and Nutrition Examination Survey 1999-2004. J Atheroscler Thromb 2010; 17 (11) 1176-1182
  • 22 Iwata A, Miura S, Tanaka T. et al. Plasma pentraxin-3 levels are associated with coronary plaque vulnerability and are decreased by statin. Coron Artery Dis 2012; 23 (05) 315-321
  • 23 Lee R, Ahn HR, Shin MH. et al. Association of plasma pentraxin-3 level with lipid levels and cardiovascular risk factors in people with no history of lipid-lowering medication: the Dong-gu study. J Atheroscler Thromb 2019; 26 (08) 738-745
  • 24 Bosutti A, Grassi G, Zanetti M. et al. Relation between the plasma levels of LDL-cholesterol and the expression of the early marker of inflammation long pentraxin PTX3 and the stress response gene p66ShcA in pacemaker-implanted patients. Clin Exp Med 2007; 7 (01) 16-23