Statins Reduce Cardiac Risk in People With High CRP

Results were reported this morning at the 2008 Scientific Sessions of the American Heart Association that may change the way preventative cardiology is practiced.

In the JUPITER trial, nearly 18,000 healthy men and women from 26 countries, who had "normal" cholesterol but elevated CRP levels, were given either 20 mg per day of the statin drug Crestor (rosuvastatin) or placebo. The study was designed as a 4-year clinical trial, but was stopped after less than 2 years, on the recommendation of an independent data monitoring board. The study was stopped because of the significant benefit being realized by those people who were receiving Crestor.

Those individuals randomized to Crestor had a 44% reduction in the primary clinical endpoint - a composite endpoint consisting of nonfatal heart attack or stroke, unstable angina, the need for stenting or bypass surgery, and cardiovascular death - than those individuals receiving placebo. People on Crestor had significant reductions in both their cholesterol levels (from their "normal" baselines) and their CRP levels.

CRP (C-reactive protein) is a marker for inflammation. Elevations in CRP levels are thought to indicate inflammation in blood vessels, a process that increases the risk of heart attack and stroke. However, it has never been shown before that treatment aimed at reducing CRP levels, in healthy people whose cholesterol levels are normal, improves the clinical outcome.

The JUPITER study shows that treating patients with statins when their CRP is elevated - even though they appear healthy and have "good" cholesterol levels - can significantly and substantially improve their cardiovascular outcomes. The results of this study should be quickly incorporated into our standard practices for reducing cardiovascular risk. Read here about CRP levels, and when they should be measured.

Read more about the JUPITER study and what it means here.

Read more about reducing your risk for heart disease here.

_Sources

Ridker PM, Danielson E, Fonseca FA et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. New Engl J Med 2008; DOI: 10.1056/NEJMoa0807646. Available at: http://www.nejm.org.