title: Clinical implications of JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) in a U.S. population insights from the ARIC (Atherosclerosis Risk in Communities) study.
abstract: OBJECTIVE
  The purpose of this study is to describe the proportion of "JUPITER-eligible" (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) individuals and clinical outcomes of individuals based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C) strata in the ARIC (Atherosclerosis Risk in Communities) study.
  
  
  BACKGROUND
  Questions remain after the JUPITER study, including whether the observed cardiovascular disease (CVD) event rates would persist with time and how these event rates would compare with other populations (lower hs-CRP and/or higher LDL-C levels).
  
  
  METHODS
  After stratification into 4 groups based on LDL-C and hs-CRP levels, with cutoffs at 130 mg/dl and 2.0 mg/l, respectively, incident CVD events were examined (mean follow-up, 6.9 years) and compared.
  
  
  RESULTS
  Of 8,907 age-eligible participants, 18.2% (n = 1,621) were JUPITER-eligible (hs-CRP > or = 2.0 mg/l, LDL-C <130 mg/dl) and had an absolute CVD risk of approximately 10.9% over a mean follow-up of 6.9 years (1.57% per year). If JUPITER hazard ratios were applied to this group, the number needed to treat to prevent 1 CVD event would be estimated at 38 over 5 years and 26 over 6.9 years.
  
  
  CONCLUSIONS
  ARIC participants with elevated hs-CRP and low LDL-C had a CVD event rate of 1.57% per year over 6.9 years, similar to the CVD event rate noted in the JUPITER study placebo group (1.36% per year over 1.9 years). The association of hs-CRP > or = 2.0 mg/l with increased CVD risk and mortality regardless of LDL-C provides us a simple method of using age and hs-CRP level for identifying higher risk individuals. (Atherosclerosis Risk in Communities study; NCT00005131).
authors.affiliation: Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Eric Y
authors.initials: EY
authors.lastname: Yang
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.forename: Zhengzheng
authors.initials: Z
authors.lastname: Tang
authors.forename: Salim S
authors.initials: SS
authors.lastname: Virani
authors.forename: Eric
authors.initials: E
authors.lastname: Boerwinkle
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.forename: Brad C
authors.initials: BC
authors.lastname: Astor
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.forename: Lloyd
authors.initials: L
authors.lastname: Chambless
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
mesh_terms: D000367:Age Factors; D002097:C-Reactive Protein / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D020521:Stroke / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
chemical_list: D008078:Cholesterol, LDL; D002097:C-Reactive Protein