JUPITER: Primary-Prevention Statin Therapy in Women Cuts Cardiovascular Risk in Half

November 25, 2009

November 25, 2009 (Orlando, Florida) Treating healthy women with low LDL cholesterol but elevated high-sensitivity C-reactive protein (hsCRP) levels with rosuvastatin (Crestor, AstraZeneca) cuts their risk of cardiovascular events in half, according to a new analysis of Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER).

The reduction in risk is consistent with the reduction observed in the overall trial, and with the 42% benefit observed in men.

"The prespecified gender-specific analyses from JUPITER are crucial for writing evidence-based guidelines," lead JUPITER investigator Dr Paul Ridker (Brigham and Women's Hospital, Boston, MA) told heartwire . "We now know that many men and women who are outside current guidelines are in fact at substantive vascular risk if hsCRP is elevated, and we now have clear evidence that statin therapy can markedly reduce that risk."

The sex-specific analysis was presented here at the American Heart Association 2009 Scientific Sessions.

46% Reduction in Risk of Cardiovascular Events

Briefly, the overall JUPITER trial consisted of 17 802 healthy men and women assigned to rosuvastatin 20 mg or placebo. It was designed to assess whether statin therapy should be given to apparently healthy individuals with normal LDL cholesterol levels but elevated CRP levels (>2.0 mg/L). As reported by heartwire , treatment with rosuvastatin significantly reduced the primary composite end point 44% compared with placebo.

In this latest analysis, Ridker, along with Dr Samia Mora (Brigham and Women's Hospital), presented data on 6801 women in the JUPITER trial. Like the overall findings, treatment with rosuvastatin 20 mg significantly reduced the relative risk of the primary end point--a composite of myocardial infarction, stroke, revascularization, hospitalization for unstable angina, and death from cardiovascular causes--by 46%. The largest reduction observed was in the need for revascularization, which was reduced 76% compared with placebo.

Ridker said there are virtually no primary-prevention studies in women, and this trial supports the use of statins based on a marker of inflammation. He noted that the recently updated Canadian lipid guidelines reflect the JUPITER trial data, a change reported by heartwire , and now recommend hsCRP evaluation for those at "intermediate risk."

JUPITER was supported by AstraZeneca. Ridker reports having received research grant support from AstraZeneca, Merck, Abbott, Roche, and Sanofi-Aventis, and consulting or lecture fees from AstraZeneca, Novartis, Merck, Merck-Schering Plough, Sanofi-Aventis, ISIS, Dade-Behring, and Vascular Biogenics; he is listed as a coinventor on patents held by the Brigham and Women's Hospital that relate to the use of inflammatory biomarkers in cardiovascular disease, which have been licensed to several entities, including AstraZeneca.

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