Cardiovascular event reduction and adverse events among subjects attaining low-density lipoprotein cholesterol <50 mg/dl with rosuvastatin. The JUPITER trial (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin)
- PMID: 21492764
- DOI: 10.1016/j.jacc.2010.09.082
Cardiovascular event reduction and adverse events among subjects attaining low-density lipoprotein cholesterol <50 mg/dl with rosuvastatin. The JUPITER trial (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin)
Abstract
Objectives: The purpose of this study was to assess the impact on cardiovascular and adverse events of attaining low-density lipoprotein cholesterol (LDL-C) levels <50 mg/dl with rosuvastatin in apparently healthy adults in the JUPITER (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) trial.
Background: The safety and magnitude of cardiovascular risk reduction conferred by treatment to LDL-C levels below current recommended targets remain uncertain.
Methods: A cohort of 17,802 apparently healthy men and women with high-sensitivity C-reactive protein ≥2 mg/l and LDL-C <130 mg/dl were randomly allocated to rosuvastatin 20 mg daily or placebo, and followed up for all-cause mortality, major cardiovascular events, and adverse events. In a post-hoc analysis, participants allocated to rosuvastatin were categorized as to whether or not they had a follow-up LDL-C level <50 mg/dl.
Results: During a median follow-up of 2 years (range up to 5 years), rates of the primary trial endpoint were 1.18, 0.86, and 0.44 per 100 person-years in the placebo group (n = 8,150) and rosuvastatin groups without LDL-C <50 mg/dl (n = 4,000) or with LDL-C <50 mg/dl (n = 4,154), respectively (fully-adjusted hazard ratio: 0.76; 95% confidence interval: 0.57 to 1.00 for subjects with no LDL-C <50 mg/dl vs. placebo and 0.35, 95% confidence interval: 0.25 to 0.49 for subjects attaining LDL-C <50 mg/dl; p for trend <0.0001). For all-cause mortality, corresponding event rates were 0.67, 0.65, and 0.39 (p for trend = 0.004). Rates of myalgia, muscle weakness, neuropsychiatric conditions, cancer, and diabetes mellitus were not significantly different among rosuvastatin-allocated participants with and without LDL-C <50 mg/dl.
Conclusions: Among adults with LDL-C <130 mg/dl and high-sensitivity C-reactive protein ≥2 mg/l, rosuvastatin-allocated participants attaining LDL-C <50 mg/dl had a lower risk of cardiovascular events without a systematic increase in reported adverse events.
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Similar articles
-
Number needed to treat with rosuvastatin to prevent first cardiovascular events and death among men and women with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein: justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin (JUPITER).Circ Cardiovasc Qual Outcomes. 2009 Nov;2(6):616-23. doi: 10.1161/CIRCOUTCOMES.109.848473. Epub 2009 Sep 22. Circ Cardiovasc Qual Outcomes. 2009. PMID: 20031900 Clinical Trial.
-
Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER)--can C-reactive protein be used to target statin therapy in primary prevention?Am J Cardiol. 2006 Jan 16;97(2A):33A-41A. doi: 10.1016/j.amjcard.2005.11.014. Epub 2005 Dec 1. Am J Cardiol. 2006. PMID: 16442935 Review.
-
Rosuvastatin: a review of its use in the prevention of cardiovascular disease in apparently healthy women or men with normal LDL-C levels and elevated hsCRP levels.Am J Cardiovasc Drugs. 2010;10(6):383-400. doi: 10.2165/11204600-000000000-00000. Am J Cardiovasc Drugs. 2010. PMID: 21090831 Review.
-
Prevalence of low low-density lipoprotein cholesterol with elevated high sensitivity C-reactive protein in the U.S.: implications of the JUPITER (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin) study.J Am Coll Cardiol. 2009 Mar 17;53(11):931-5. doi: 10.1016/j.jacc.2008.12.010. J Am Coll Cardiol. 2009. PMID: 19281922 Clinical Trial.
-
Baseline characteristics of participants in the JUPITER trial, a randomized placebo-controlled primary prevention trial of statin therapy among individuals with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein.Am J Cardiol. 2007 Dec 1;100(11):1659-64. doi: 10.1016/j.amjcard.2007.09.072. Epub 2007 Oct 24. Am J Cardiol. 2007. PMID: 18036365 Clinical Trial.
Cited by
-
Non-antibody Approaches to Proprotein Convertase Subtilisin Kexin 9 Inhibition: siRNA, Antisense Oligonucleotides, Adnectins, Vaccination, and New Attempts at Small-Molecule Inhibitors Based on New Discoveries.Front Cardiovasc Med. 2019 Jan 29;5:199. doi: 10.3389/fcvm.2018.00199. eCollection 2018. Front Cardiovasc Med. 2019. PMID: 30761308 Free PMC article. Review.
-
Association of Patient Perceptions of Cardiovascular Risk and Beliefs on Statin Drugs With Racial Differences in Statin Use: Insights From the Patient and Provider Assessment of Lipid Management Registry.JAMA Cardiol. 2018 Aug 1;3(8):739-748. doi: 10.1001/jamacardio.2018.1511. JAMA Cardiol. 2018. PMID: 29898219 Free PMC article.
-
Exploring the Association between Low-Density Lipoprotein Subfractions and Major Adverse Cardiovascular Outcomes-A Comprehensive Review.Int J Mol Sci. 2023 Apr 3;24(7):6669. doi: 10.3390/ijms24076669. Int J Mol Sci. 2023. PMID: 37047642 Free PMC article. Review.
-
Pharmacotherapies for lipid modification: beyond the statins.Nat Rev Cardiol. 2013 Oct;10(10):560-70. doi: 10.1038/nrcardio.2013.117. Epub 2013 Aug 20. Nat Rev Cardiol. 2013. PMID: 23959229 Review.
-
Can Clinicians Start Prescribing Inclisiran for Hypercholesterolemia Today? A Review of Clinical Studies for Internal Medicine Physicians and Endocrinologists.Cureus. 2021 Jul 27;13(7):e16664. doi: 10.7759/cureus.16664. eCollection 2021 Jul. Cureus. 2021. PMID: 34462692 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials