The gravity of JUPITER (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin).
In the recently published Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) study, a large, randomized, placebo-controlled trial, rosuvastatin proved to be safe and remarkably effective in the setting of primary prevention. In patients without coronary heart disease or diabetes, with a baseline low-density lipoprotein cholesterol (LDL-C) level < 130 mg/dL and a C-reactive protein (CRP) > or = 2mg/L, a statin-induced LDL-C reduction of 50% reduced serious cardiac events by about 50%, including in women and the elderly, and also lowered all-cause mortality. The mean on-treatment LDL-C level (55 mg/dL) in the rosuvastatin arm of JUPITER was about in the mid-range of the physiologically normal levels. C-reactive protein screening should be considered, especially in patients without preexisting indications for statin therapy. In general, the CRP-lowering efficacy of statin therapy is directly and significantly correlated with its LDL-C-lowering activity. Simvastatin, at the 80-mg daily dose, is more toxic to muscles and liver than other statins at their highest dose, and thus should be used with caution.
O'Keefe
James H
JH
Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO 64111, USA. jhokeefe@cc-pc.com
Carter
Maia D
MD
Lavie
Carl J
CJ
Bell
David S H
DS
D002097:C-Reactive Protein / Q000187:drug effects / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D005464:Fluorobenzenes / Q000627:therapeutic use*; D018466:Gravity Sensing / Q000502:physiology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D011322:Primary Prevention / Q000379:methods*; D011743:Pyrimidines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome
D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D002097:C-Reactive Protein