Race, ethnicity, and the efficacy of rosuvastatin in primary prevention: the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial

Race, ethnicity, and the efficacy of rosuvastatin in primary prevention: the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial

Author Albert, Michelle A. Google Scholar
Glynn, Robert J. Google Scholar
Fonseca, Francisco A. H. Autor UNIFESP Google Scholar
Lorenzatti, Alberto J. Google Scholar
Ferdinand, Keith C. Google Scholar
MacFadyen, Jean G. Google Scholar
Ridker, Paul M. Google Scholar
Institution Harvard Univ
Universidade Federal de São Paulo (UNIFESP)
Hosp Cordoba
Emory Univ
Abstract Objectives the aim of this study was to evaluate the effect of statin treatment in primary prevention of cardiovascular events in different race/ethnic groups.Background Clinical trial evidence about the efficacy of statins in the primary prevention of cardiovascular events among nonwhites is uncertain.Methods JUPITER trial, a randomized, double-blind, placebo-controlled evaluation of rosuvastatin 20 mg in the primary prevention of myocardial infarction (MI), stroke, arterial revascularization, hospitalization for unstable angina, and cardiovascular death included 12,683 whites and 5,117 nonwhites with low-density lipoprotein levels <130 mg/dL and high-sensitivity C-reactive protein levels >= 2.0 mg/L.Results Random allocation to rosuvastatin resulted in a 45% reduction in the primary end point among whites (hazard ratio [HR] 0.55, 95% CI 0.43-0.69) and a 37% reduction among nonwhites (HR 0.63, 95% CI 0.41-0.99). Blacks (HR 0.65, 95% CI 0.35-1.22) and Hispanics (HR 0.58, 95% CI 0.25-1.39) had similar risk reductions. Among nonwhites in the placebo group, the stroke rate exceeded the MI rate (0.44 vs 0.20 per 100 person-years); an opposite pattern was observed among whites (0.31 vs 0.42 per 100 person-years). Nonwhites had higher death rates than whites (2.25 vs 0.93 per 100 person-years); however, all-cause mortality was similar at 20% with rosuvastatin treatment in both participant groups.Conclusions When used in primary prevention among individuals with low-density lipoprotein <130 mg/dL and high-sensitivity C-reactive protein >= 2 mg/L, rosuvastatin significantly reduced first MI, stroke, arterial revascularization, hospitalization for unstable angina, and cardiovascular death among whites and nonwhites. (Am Heart J 2011;162:106-114.e2.)
Language English
Sponsor Astra-Zeneca
Lerner Cardiovascular Award
Doris Duke and Donald W. Reynolds Foundations
Merck
Association of Black Cardiologists
Vascular Biology Working Group
Novartis
Abbott
Roche
SanofiAventis
MerckSchering- Plough
Sanofi-Aventis
Isis
Dade Behring
Vascular Biogenics
Bristol Myers-Squibb
Takeda
Pfizer
Forest Laboratories
Daiichi Sankyo Inc
Date 2011-07-01
Published in American Heart Journal. New York: Mosby-Elsevier, v. 162, n. 1, p. 106-U147, 2011.
ISSN 0002-8703 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 106-U147
Origin http://dx.doi.org/10.1016/j.ahj.2011.03.032
Access rights Closed access
Type Article
Web of Science ID WOS:000292542400024
URI http://repositorio.unifesp.br/handle/11600/33850

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