Denise L. Campbell-Scherer, MD, PhD; Victor M. Montori, MD, MSc
In healthy older adults with elevated C-reactive protein levels who do not have hyperlipidemia, does rosuvastatin prevent major cardiovascular (CV) events?
Randomized placebo-controlled trial (Justification for the Use of Statins in Prevention:
an Intervention Trial Evaluating Rosuvastatin [JUPITER]). 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 no history of CV disease, high-sensitivity C-reactive protein levels ≥ 2.0 mg/L, low-density lipoprotein cholesterol levels < 3.4 mmol/L (130 mg/dL), and triglyceride levels < 5.6 mmol/L (500 mg/dL). Exclusion criteria included previous use of a lipid-lowering drug; uncontrolled hypertension or hypothyroidism; and diabetes.
Rosuvastatin, 20 mg daily (n = 8901), or placebo (n = 8901) for ≤ 5 years.
A composite of CV events (nonfatal myocardial infarction or stroke, hospitalization for unstable angina, arterial revascularization procedure, or confirmed CV death), components of the primary composite endpoint, and death from any cause.
99.5% (intention-to-treat analysis).
Rosuvastatin reduced risk for the composite endpoint, 3 of 5 components, and death from any cause (Table).
In healthy older adults with elevated C-reactive protein levels who do not have hyperlipidemia, rosuvastatin reduced stroke and myocardial infarction.
Rosuvastatin vs placebo in healthy older persons with elevated C-reactive protein†
†Abbreviations defined in Glossary. RRR, NNT, and CI calculated from data in article.
‡Nonfatal myocardial infarction or stroke, hospitalization for unstable angina, arterial revascularization procedure, or confirmed cardiovascular death.
§Data provided by author. The adjudication committee set a very high threshold for classifying deaths as cardiovascular; as a result, some deaths not classified as such may have been cardiovascular deaths.
Campbell-Scherer DL, Montori VM. Rosuvastatin prevented major cardiovascular events in persons with elevated C-reactive protein. Ann Intern Med. ;150:JC1–4. doi: 10.7326/0003-4819-150-2-200901200-02004
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Published: Ann Intern Med. 2009;150(2):JC1-4.
Cardiology, Coronary Risk Factors, Dyslipidemia.
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