title: C-Reactive Protein: How Has JUPITER Impacted Clinical Practice?
abstract: Inflammation plays a pivotal role in all phases of atherosclerosis. High-sensitivity C-reactive protein (hsCRP), the best characterized biomarker of inflammation, is an independent predictor of future cardiovascular (CV) events and can add further insight to risk stratification. Assessment of hsCRP levels in clinical practice is feasible and inexpensive. Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) was a landmark primary prevention trial that enrolled 17,802 apparently healthy men and women with low-density lipoprotein cholesterol levels of less than 130 mg/dL and hsCRP levels of 2 mg/L or higher and randomly assigned them to rosuvastatin, 20 mg daily, or placebo. The trial demonstrated that treatment with statin was associated with significant lowering of hsCRP (37%), with 44% reduction in incident CV and 20% reduction in all-cause mortality. These compelling data from the JUPITER trial should encourage changes in our approach toward primary prevention of CV disease and lipid-lowering therapy, as these data shift the focus toward a link between inflammation, statin therapy, and prevention of atherosclerotic CV diseases.
authors: Department of Cardiology, Ochsner Clinic Foundation, New Orleans, LA.
authors: Anil
authors: A
authors: Verma
authors: Carl J
authors: CJ
authors: Lavie
authors: Richard V
authors: RV
authors: Milani
references: J Am Coll Cardiol. 2002 Feb 20;39(4):632-7
references: 11849862
references: Circulation. 1998 Sep 1;98(9):839-44
references: 9738637
references: Circulation. 2002 Feb 19;105(7):800-3
references: 11854118
references: N Engl J Med. 2004 Apr 1;350(14):1387-97
references: 15070788
references: Arterioscler Thromb Vasc Biol. 2003 Aug 1;23(8):1398-404
references: 12805076
references: J Am Coll Cardiol. 2004 Mar 17;43(6):1056-61
references: 15028366
references: N Engl J Med. 1999 Jan 14;340(2):115-26
references: 9887164
references: Circulation. 2001 Apr 3;103(13):1813-8
references: 11282915
references: Curr Opin Lipidol. 2009 Jun;20(3):182-9
references: 19369869
references: Am J Med Sci. 2009 Dec;338(6):486-92
references: 20010156
references: Am J Cardiol. 2003 Jul 1;92(1):50-4
references: 12842245
references: Am J Pathol. 2001 Mar;158(3):1039-51
references: 11238052
references: Nat Clin Pract Cardiovasc Med. 2008 Oct;5(10):621-35
references: 18711404
references: Circulation. 2003 Jan 28;107(3):398-404
references: 12551862
references: Circulation. 1998 May 12;97(18):1837-47
references: 9603539
references: Circ Res. 2007 May 25;100(10):1452-9
references: 17446434
references: N Engl J Med. 2000 Oct 19;343(16):1139-47
references: 11036119
references: N Engl J Med. 2008 Nov 20;359(21):2195-207
references: 18997196
references: Am J Cardiol. 2001 Dec 1;88(11):1264-9
references: 11728354
references: Circulation. 2003 Jan 28;107(3):391-7
references: 12551861
references: Stroke. 2001 Nov;32(11):2575-9
references: 11692019
references: Circulation. 1998 Feb 10;97(5):425-8
references: 9490235
references: Arch Intern Med. 2005 Nov 28;165(21):2479-84
references: 16314544
references: Am J Cardiol. 2005 Nov 1;96(9):1273-7
references: 16253596
references: N Engl J Med. 2005 Jan 6;352(1):20-8
references: 15635109
references: N Engl J Med. 2005 Apr 21;352(16):1685-95
references: 15843671
references: Circulation. 2000 Oct 31;102(18):2165-8
references: 11056086
references: Mayo Clin Proc. 2009 Apr;84(4):373-83
references: 19339657
references: Circulation. 2006 Feb 14;113(6):e85-151
references: 16407573
references: N Engl J Med. 2002 Nov 14;347(20):1557-65
references: 12432042
references: Circulation. 2002 Mar 5;105(9):1135-43
references: 11877368
references: Circulation. 2000 Aug 29;102(9):1000-6
references: 10961964
references: Circulation. 1998 May 26;97(20):2007-11
references: 9610529
references: Postgrad Med. 2009 May;121(3):113-8
references: 19491548
references: Circulation. 2007 Feb 6;115(5):e69-171
references: 17194875
references: N Engl J Med. 2000 Mar 23;342(12):836-43
references: 10733371
references: JAMA. 2007 Feb 14;297(6):611-9
references: 17299196
references: Circulation. 2002 Apr 30;105(17):2019-23
references: 11980679
references: JAMA. 1998 May 27;279(20):1615-22
references: 9613910
references: JAMA. 2001 Jul 18;286(3):327-34
references: 11466099
references: Circulation. 2003 Oct 21;108(16):1930-2
references: 14530191