Monday, September 28, 2009

Rosuvastatin Merits Wider Use for Heart Disease Prevention

Good risk reduction profile in those with low cholesterol, high C-reactive protein levels


28 sept 2009-- Prescribing rosuvastatin for patients with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein levels has enough benefits in terms of number needed to treat values to merit wide use in primary prevention of cardiovascular events, according to a study published online Sept. 22 in Circulation: Cardiovascular Quality and Outcomes.

Paul M. Ridker, M.D., of Harvard Medical School in Boston, and colleagues analyzed data from a trial evaluating rosuvastatin in 17,802 apparently healthy subjects with low-density lipoprotein cholesterol levels below 130 mg/dL and high-sensitivity C-reactive protein levels at or above 2 mg/L who were randomized to receive either 20 mg rosuvastatin or placebo.

The researchers looked at absolute risk reductions and the number needed to treat for a range of end points, time frames and sub-groups, and found that for myocardial infarction, stroke, revascularization or death, the five-year number needed to treat was 20, and that the number needed to treat was less than 50 for all sub-groups. The calculations compare favorably with those for other primary cardiovascular prevention therapies, the investigators note.

"The current analyses indicate that number needed to treat values associated with statin therapy among men and women with low levels of low-density lipoprotein cholesterol but elevated high-sensitivity C-reactive protein are at least comparable to number needed to treat values observed in prior primary prevention trials evaluating statin therapy for the treatment of hyperlipidemia," the authors write. "These data may be informative in policy discussions regarding new guidelines for the primary prevention of cardiovascular disease."

The JUPITER trial was funded by AstraZeneca; several authors reported financial relationships with the pharmaceutical industry.

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