Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein

Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein

Autor Ridker, Paul M. Google Scholar
Danielson, Eleanor Google Scholar
Fonseca, Francisco A. H. Autor UNIFESP Google Scholar
Genest, Jacques Google Scholar
Gotto, Antonio M. Google Scholar
Kastelein, John J. P. Google Scholar
Koenig, Wolfgang Google Scholar
Libby, Peter Google Scholar
Lorenzatti, Alberto J. Google Scholar
MacFadyen, Jean G. Google Scholar
Nordestgaard, Borge G. Google Scholar
Shepherd, James Google Scholar
Willerson, James T. Google Scholar
Glynn, Robert J. Google Scholar
JUPITER Study Grp Google Scholar
Instituição Harvard Univ
Universidade Federal de São Paulo (UNIFESP)
McGill Univ
Cornell Univ
Univ Amsterdam
Univ Ulm
Hosp Cordoba
Copenhagen Univ Hosp
Univ Glasgow
St Lukes Episcopal Hosp
Resumo Background: Increased levels of the inflammatory biomarker high-sensitivity C-reactive protein predict cardiovascular events. Since statins lower levels of high-sensitivity C-reactive protein as well as cholesterol, we hypothesized that people with elevated high-sensitivity C-reactive protein levels but without hyperlipidemia might benefit from statin treatment.Methods: We randomly assigned 17,802 apparently healthy men and women with low-density lipoprotein (LDL) cholesterol levels of less than 130 mg per deciliter (3.4 mmol per liter) and high-sensitivity C-reactive protein levels of 2.0 mg per liter or higher to rosuvastatin, 20 mg daily, or placebo and followed them for the occurrence of the combined primary end point of myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or death from cardiovascular causes.Results: the trial was stopped after a median follow-up of 1.9 years (maximum, 5.0). Rosuvastatin reduced LDL cholesterol levels by 50% and high-sensitivity C-reactive protein levels by 37%. the rates of the primary end point were 0.77 and 1.36 per 100 person-years of follow-up in the rosuvastatin and placebo groups, respectively (hazard ratio for rosuvastatin, 0.56; 95% confidence interval [CI], 0.46 to 0.69; P<0.00001), with corresponding rates of 0.17 and 0.37 for myocardial infarction (hazard ratio, 0.46; 95% CI, 0.30 to 0.70; P=0.0002), 0.18 and 0.34 for stroke (hazard ratio, 0.52; 95% CI, 0.34 to 0.79; P=0.002), 0.41 and 0.77 for revascularization or unstable angina (hazard ratio, 0.53; 95% CI, 0.40 to 0.70; P<0.00001), 0.45 and 0.85 for the combined end point of myocardial infarction, stroke, or death from cardiovascular causes (hazard ratio, 0.53; 95% CI, 0.40 to 0.69; P<0.00001), and 1.00 and 1.25 for death from any cause (hazard ratio, 0.80; 95% CI, 0.67 to 0.97; P=0.02). Consistent effects were observed in all subgroups evaluated. the rosuvastatin group did not have a significant increase in myopathy or cancer but did have a higher incidence of physician-reported diabetes.Conclusions: in this trial of apparently healthy persons without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels, rosuvastatin significantly reduced the incidence of major cardiovascular events. (ClinicalTrials.gov number, NCT00239681.).
Idioma Inglês
Financiador AstraZeneca
Novartis
Merck
Abbott
Roche
Sanofi-Aventis
Merck-Schering-Plough
Isis
Dade Behring
Vascular Biogenics
Pfizer
Merck Frosst
Resverlogix
Dupont
Aegerion
Arisaph
Kowa
Genentech
Martek
Reliant
Genzyme
GlaxoSmithKline
Boehringer Ingelheim
DiaDexus
Medlogix
Anthera
Bristol-Myers Squibb
VIA Pharmaceuticals
Interleukin Genetics
Kowa Research Institute
Takeda
BG Medicine
Oxford Biosciences
Data de publicação 2008-11-20
Publicado em New England Journal of Medicine. Waltham: Massachusetts Medical Soc, v. 359, n. 21, p. 2195-2207, 2008.
ISSN 0028-4793 (Sherpa/Romeo, fator de impacto)
Publicador Massachusetts Medical Soc
Extensão 2195-2207
Fonte http://dx.doi.org/10.1056/NEJMoa0807646
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000260994000003
Endereço permanente http://repositorio.unifesp.br/handle/11600/31041

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