Relation of Baseline High-Sensitivity C-Reactive Protein Level to Cardiovascular Outcomes With Rosuvastatin in the Justification for Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) - 11/08/11
, Jean MacFadyen, BA a, Peter Libby, MD b, Robert J. Glynn, ScD aRésumé |
In the Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER), random allocation of rosuvastatin compared to placebo among primary prevention patients with a low-density lipoprotein cholesterol level of <130 mg/dl and a high-sensitivity C-reactive protein (hs-CRP) level of ≥2 mg/L resulted in a highly significant 44% reduction in major vascular events. However, the relation of baseline hs-CRP levels to risk within JUPITER has not previously been described and has been an area of controversy for study interpretation. As reported in the present study for the first time, despite enrolling patients with a constrained range of values, increasing baseline hs-CRP levels within JUPITER were nonetheless associated with increasing vascular risk in analyses treating hs-CRP as a continuous variable, as an ordinal variable, and as a threshold variable. As anticipated, the relative risk reduction associated with rosuvastatin was similar in magnitude across the tertile and threshold levels of entry hs-CRP. In conclusion, as the absolute risk increased with increasing hs-CRP, the absolute risk reduction associated with rosuvastatin within JUPITER was also greatest among those with the greatest entry hs-CRP levels.
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| The JUPITER trial was investigator initiated and supported by AstraZeneca US (Wilmington, Delaware). During the project period, Dr. Ridker received investigator-initiated research grant support from the National Heart, Lung, and Blood Institute (Bethesda, Maryland), the National Cancer Institute (Bethesda, Maryland), the Donald W. Reynolds Foundation (Las Vegas, Nevada), the Leducq Foundation (Paris, France), AstraZeneca (Wilmington, Delaware), Novartis (Basel, Switzerland), Merck (Whitehouse Station, New Jersey), Abbott (Abbott Park, Illinois), Roche (Basel, Switzerland), and SanofiAventis (Paris, France); consulting fees from AstraZeneca (Wilmington, Delaware), Novartis (Basel, Switzerland), Merck (Whitehouse Station, New Jersey), Merck-Schering Plough (Kenilworth, New Jersey), SanofiAventis (Paris, France), ISIS (Carlsbad, California), Seimens (Malvern, Pennsylvania), and Vascular Biogenics (Tel Aviv, Israel); and is listed as a co-inventor on patents held by the Brigham and Women's Hospital (Boston, Massachusetts) that relate to the use of inflammatory biomarkers in cardiovascular disease and have been licensed to Seimens (Malvern, Pennsylvania) and AstraZeneca (Wilmington, Delaware) . Dr. Libby received consulting fees from Via Pharmaceutical (San Francisco, California), Interleukin Genetics (Waltham, Massachusetts), Bind Biosciences (Cambridge, Massachusetts), Carolus Therapeutics (San Diego, California), and Kowa Research Institute (Nagoya, Japan). Dr. Glynn received research grant support form the National Heart, Lung, and Blood Institute (Bethesda, Maryland), AstraZeneca (Wilmington, Delaware), and Bristol-Myers Squibb (New York, New York). |
Vol 106 - N° 2
P. 204-209 - juillet 2010 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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