***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Prospect i ve studies indicate that baseline levels of C-reactive protein ( CRP ) , the prototypic marker of inflammation , are associated with an increased risk for cardiovascular events . Limited studies have examined therapies that influence high-sensitive CRP ( hs-CRP ) levels , especially in hyperlipidemic patients . Thus , we tested the effects of 3 hydroxymethyl glutaryl coenzyme A reductase inhibitors ( statins ) , simvastatin ( 20 mg/d ) , pravastatin ( 40 mg/d ) , and atorvastatin ( 10 mg/d ) , on levels of hs-CRP in a r and omized , double-blind , crossover trial of 22 patients with combined hyperlipidemia ( LDL cholesterol > 130 mg/dL and triglycerides of 200 to 600 mg/dL ) . Methods and Results After 6 weeks of an American Heart Association Step 1 diet , fasting blood sample s were drawn at baseline and after 6 weeks of therapy with each drug . hs-CRP levels were significantly decreased after treatment with all 3 statins compared with baseline ( median values : baseline , 2.6 mg/L ; atorvastatin , 1.7 mg/L ; simvastatin , 1.7 mg/L ; and pravastatin , 1.9 mg/L;P < 0.025 ) . The reductions obtained with the 3 statins were similar . In addition , there was no significant effect on either plasma interleukin-6 or interleukin-6 soluble receptor levels . There was no relationship between reductions in hs-CRP and LDL cholesterol . Conclusions Pravastatin , simvastatin , and atorvastatin significantly decreased levels of hs-CRP . These data support an anti-inflammatory effect of these drugs Our objective was to examine the influence of various demographic , clinical , and enrollment biochemical variables on the long-term survival of continuous ambulatory peritoneal dialysis ( CAPD ) patients . This was a prospect i ve cohort study investigating the relationship between demographics and enrollment biochemical markers and mortality in CAPD patients in a CAPD unit in a large tertiary care teaching hospital . One hundred and sixtynine patients in the CAPD program were enrolled between 1989 and 1994 , and were followed up to 60 months . Independent predictors of mortality determined by Cox proportional hazards model included age , diabetes , serum albumin and creatinine . Enrollment level of serum albumin , and creatinine can predict mortality in CAPD patients up to 60 months . Markers of visceral and somatic nutrition at enrollment are important predictors of mortality in CAPD patients up to five years Statins are first-line pharmacotherapeutic agents for hypercholesterolemia treatment in humans . However the effects of statins in animal models of atherosclerosis are not very consistent . Thus we wanted to evaluate whether atorvastatin possesses hypolipidemic and anti-inflammatory effects in mice lacking apolipoprotein E/low-density lipoprotein receptor ( apoE/LDLR-deficient mice ) . Two-month-old female apoE/LDLR-deficient mice ( n=24 ) were r and omly subdivided into 3 groups . The control group of animals ( n=8 ) was fed with the western type diet ( atherogenic diet ) and in other two groups atorvastatin was added to the atherogenic diet at the dosage of either 10 mg/kg or 100 mg/kg per day for a period of 2 months . Biochemical analysis of lipids , ELISA analysis of monocyte chemotactic protein-1 ( MCP-1 ) in blood , quantification of lesion size and expression of vascular cell adhesion molecule-1 ( VCAM-1 ) and intercellular cell adhesion molecule-1 ( ICAM-1 ) in the atherosclerotic lesion by means of immunohistochemistry and Western blot analysis were performed . The biochemical analysis showed that administration of atorvastatin ( 100 mg/kg/day ) significantly decreased level of total cholesterol , lipoproteins ( VLDL and LDL ) , triacylglycerol , and moreover significantly increased level of HDL . ELISA analysis showed that atorvastatin significantly decreased levels of MCP-1 in blood and immunohistochemical and Western blot analysis showed significant reduction of VCAM-1 and ICAM-1 expression in the vessel wall after atorvastatin treatment ( 100 mg/kg/day ) . In conclusion , we demonstrated here for the first time strong hypolipidemic and anti-inflammatory effects of atorvastatin in apoE/LDLR-deficient mice . Thus , we propose that apoE/LDLR-deficient mice might be a good animal model for the study of statin effects on potential novel markers involved in atherogenesis and for the testing of potential combination treatment of new hypolipidemic substances with statins BACKGROUND Atherosclerosis , a major problem in patients on chronic hemodialysis , has been characterized as an inflammatory disease . C-reactive protein ( CRP ) , the prototypical acute phase protein in humans , is a predictor of cardiovascular mortality in the general population . We hypothesize that several of the classic , as well as nontraditional , cardiovascular risk factors may respond to acute phase reactions . An activated acute phase response may influence or predict cardiovascular risk . METHODS In 280 stable hemodialysis patients , serum lipids , apolipoproteins ( apo ) A-I and B , lipoprotein(a ) [ Lp(a ) ] , fibrinogen , and serum albumin ( Salb ) were determined in relation to CRP and serum amyloid A ( SAA ) , two sensitive markers of an acute phase response . Mortality was monitored prospect ively over a two year period . RESULTS Serum CRP and SAA were found to be elevated ( more than 8 and more than 10 mg/liter , respectively ) in 46 % and 47 % of the patients in the absence of clinical ly apparent infection . Patients with elevated CRP or SAA had significantly higher serum levels of Lp(a ) , higher plasma fibrinogen , and lower serum levels of high-density lipoprotein cholesterol , apo A-I , and Salb than patients with normal CRP or SAA . The rise in Lp(a ) concentration was restricted to patients exhibiting high molecular weight apo(a ) isoforms . During follow-up , 72 patients ( 25.7 % ) had died , mostly due to cardiovascular events ( 58 % ) . Overall mortality and cardiovascular mortality were significantly higher in patients with elevated CRP ( 31 % vs. 16 % , P < 0.0001 , and 23 % vs. 5 % , P < 0.0001 , respectively ) or SAA ( 29 % vs. 19 % , P = 0.004 , and 20 vs. 10 % , P = 0.008 , respectively ) and were also higher in patients with Salb of lower than 40 g/liter ( 44 % vs. 14 % , P < 0.0001 , and 34 % vs. 6 % , P < 0.0001 , respectively ) . Univariate Cox regression analysis demonstrated that age , diabetes , pre-existing cardiovascular disease , body mass index , CRP , SAA , Salb , fibrinogen , apo A-I , and Lp(a ) were significantly associated with the risk of all-cause and cardiovascular mortality . During multivariate regression analysis , SAA , fibrinogen , apo A-I , and Lp(a ) lost their predictive values , but age and CRP remained powerful independent predictors of both overall death and cardiovascular death . CONCLUSION These results suggest that a considerable number of hemodialysis patients exhibit an activated acute phase response , which is closely related to high levels of atherogenic vascular risk factors and cardiovascular death . The mechanisms of activated acute phase reaction in patients on chronic hemodialysis remain to be identified . A successful treatment of the inflammatory condition may improve long-term survival in these patients BACKGROUND Arterial stiffness assessed by pulse wave velocity ( PWV ) predicts all-cause and cardiovascular mortality in diabetic patients with end-stage renal disease . We studied the preventive effects of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor , fluvastatin , on arterial PWV values in this population . METHODS Twenty-two patients with normal serum lipid levels received fluvastatin ( 20 mg/day p.o . ) or a placebo for 6 months . Their serum lipid levels , serum levels of C-reactive protein ( CRP ) , arterial PWV , and ankle brachial indexes ( ABI ) were determined before , and 3 and 6 months after taking the medication to evaluate arterial stiffness . RESULTS At the beginning of the follow-up , there were no differences in age , blood pressure , body mass index , serum haemoglobin A1c level , serum CRP level , serum lipid levels , PWV or ABI between the placebo- ( n=10 ) and the fluvastatin-treated patients ( n=12 ) . After 6 months , the PWV and the serum oxidized low-density lipoprotein cholesterol ( LDL-C ) level increased significantly ( from 1969+/-140 to 2326+/-190 cm/s and 70.4+/-13.8 to 91.8+/-15.5 U/l , respectively ) in the placebo-treated patients . However , the fluvastatin group had a significantly reduced PWV ( from 1991+/-162 to 1709+/-134 cm/s ) , oxidized LDL-C serum levels ( from 89.0+/-9.6 to 73.0+/-5.8 U/l ) and CRP serum levels ( from 0.97+/-0.32 to 0.26+/-0.16 mg/dl ) compared with those in the placebo group . CONCLUSIONS Long-term administration of fluvastatin prevents further worsening of arterial biomechanics in haemodialysis patients with type 2 diabetes mellitus , even in the presence of serum lipid levels in the normal range BACKGROUND Cardiovascular disease is the most common cause of mortality in patients with end-stage renal disease . Cardiovascular benefits of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors ( statins ) have been clearly established in the general population , but not in dialysis patients . This study examined statin prescription patterns and assessed the relationship between statin prescription and clinical outcomes in hemodialysis ( HD ) patients . METHODS Data were analyzed from the Dialysis Outcomes and Practice Patterns Study , a prospect i ve observational study of HD patients r and omly selected from representative dialysis facilities in France , Germany , Italy , Spain , the United Kingdom , Japan , and the United States . Predictors of statin prescription were investigated by means of logistic regression . Cox regression models tested the association between statin prescription and risk for mortality and cardiac events , with adjustments for common demographic factors and comorbid conditions . RESULTS Statins were prescribed for 11.8 % of HD patients overall . Most facilities ( 81.2 % ) prescribed statins to less than 20 % of their patients . Patients prescribed statins had a 31 % lower relative risk for death compared with those not prescribed statins ( P < 0.0001 ) . Statins were associated with a 23 % lower cardiac mortality risk ( P = 0.03 ) and a 44 % lower noncardiac mortality risk ( P < 0.0001 ) . At a facility level , prescribing statins was associated with lower overall mortality rate , with a 5 % lower risk for every 10 % increase in number of patients prescribed statins within the facility ( P = 0.02 ) . CONCLUSION Statin prescription is associated with reduced mortality in HD patients , providing additional support for the value of statin therapy in this patient group Background : Dialysis patients have many underlying traditional and nontraditional risk factors that may predispose them to a high prevalence of cardiovascular disease . The effects of statins ( eg , atorvastatin ) on altering nontraditional lipoprotein measures in dialysis patients have not been extensively investigated . Objective : To evaluate the efficacy of atorvastatin compared with a control group in inducing changes in lipoprotein(a ) [ Lp(a ) ] , apolipoprotein ( Apo ) A-1 , Apo-B , and fibrinogen levels , as well as the conventional lipoprotein profile , in hemodialysis patients over 36 weeks ; secondary objectives were to assess changes in C-reactive protein , albumin , and safety measures . Methods : Forty-five hemodialysis patients with low-density lipoprotein cholesterol ( LDL-C ) levels greater than 100 mg/dL were r and omized to parallel groups : atorvastatin ( n = 19 ) or no treatment ( n = 26 ) . The atorvastatin dose was titrated from 10 mg to achieve an LDL-C goal of 100 mg/dL or less and therapy was continued for 36 weeks . Biochemical and lipoprotein laboratory tests for efficacy outcomes were obtained at baseline , 12 weeks , and 36 weeks . Results : The atorvastatin group exhibited clinical ly significant reductions ( 
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CONCLUSIONS Statins can improve the chronic inflammation status reflected by the decreasing of serum CRP and hs-CRP levels , whereas there is no conclusive evidence that it can improve the nutrition status .