Salvador Cruz-Flores, MD, MPH
In healthy older adults with elevated high-sensitivity C-reactive protein levels who do not have hyperlipidemia, does rosuvastatin prevent stroke?
Randomized placebo-controlled trial. ClinicalTrials.gov NCT00239681.
Blinded (patients, clinicians, data collectors, and outcome adjudication committee).*
Median 1.9 years (trial stopped early for apparent benefit).
1315 sites in 26 countries.
17 802 men ≥ 50 years of age or women ≥ 60 years of age (mean age 66 y, 62% men) who had high-sensitivity C-reactive protein levels ≥ 2.0 mg/L and low-density lipoprotein cholesterol (LDL-C) levels < 3.4 mmol/L (130 mg/dL) but no history of cardiovascular disease or diabetes.
Rosuvastatin, 20 mg/d (n = 8901), or placebo (n = 8901), for ≤ 5 years.
Stroke and transient ischemic attack (TIA).
100% (intention-to-treat analysis).
Rosuvastatin reduced risk for any stroke, nonfatal stroke, and ischemic stroke but not hemorrhagic stroke or TIA (Table). Subgroup analyses by traditional risk factors showed that the benefit of rosuvastatin was consistent across all subgroups, including those considered to be at low risk for stroke (e.g., women, nonsmokers, and persons with low body mass index, low levels of LDL-C, or Framingham risk scores ≤ 10, or without the metabolic syndrome).
In healthy older adults with elevated high-sensitivity C-reactive protein levels who do not have hyperlipidemia, rosuvastatin prevented ischemic stroke.
Rosuvastatin vs placebo in healthy older persons with elevated C-reactive protein levels†
†Abbreviations defined in Glossary. RRR, NNT, and CI calculated from data in article.
Cruz-Flores S. Rosuvastatin prevented ischemic stroke in healthy older adults with elevated C-reactive protein. Ann Intern Med. ;152:JC6–6. doi: 10.7326/0003-4819-152-12-201006150-02006
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Published: Ann Intern Med. 2010;152(12):JC6-6.
Cardiology, Coronary Risk Factors, Dyslipidemia, Geriatric Medicine, Neurology.
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