Statins modulate feedback regulation mechanisms between advanced glycation end-products and C-reactive protein: Evidence in patients with acute myocardial infarction

ObjectiveHigh sensitivity C-reactive protein (hsCRP) and advanced glycation end-products (AGEs) have been proposed as mediators in inflammation and atherosclerosis. Therefore, we studied the relation between AGE and hsCRP in patients with acute myocardial infarction (AMI).MethodsPatients with AMI diagnosis and satisfying our inclusion criteria were included during 2009–2011 in an unicentre registry of AMI patients for a cross-sectional study. The final cohort was composed of 156 patients (46.2% STEMI and 27.6% with type-2 diabetes). AGE and hsCRP were measured in plasma.ResultsDiabetic patients were older than non-diabetics (68.6 ± 10.6 vs. 60.4 ± 13.9 years; p < 0.05), presented more incidence of hypertension (62.8 vs. 36.3%; p < 0.05) and were in a higher Killip class (p < 0.05). The mean values of fluorescent AGE and hsCRP levels were 61.3 ± 49.8 AU and 2.4 ± 4.0 mg/L, respectively, and there were no differences in these parameters between diabetic and non-diabetic patients. A direct association between AGE and hsCRP levels was observed, mainly in diabetic patients (r = 0.258; p = 0.018). Importantly, this association disappeared in patients who had been treated with statins before their AMI (r = −0.055; p = 0.845), but it was maintained in non-diabetic patients naïve for statins treatment (r = 0.634; p < 0.001), independently of other treatments and confounding parameters.ConclusionsThis is the first evidence in humans of a feedback regulation mechanism between CRP and the AGE–RAGE axis modulated by statins.

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