Clinical Implications of JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) in a U.S. Population. Insights From the ARIC (Atherosclerosis Risk in Communities) Study

Eric Y. Yang, Vijay Nambi, Zhengzheng Tang, Salim S. Virani, Eric Boerwinkle, Ron C. Hoogeveen, Brad C. Astor, Thomas H. Mosley, Josef Coresh, Lloyd Chambless, Christie M. Ballantyne

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Objectives: The purpose of this study is to describe the proportion of "JUPITER-eligible" (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) individuals and clinical outcomes of individuals based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C) strata in the ARIC (Atherosclerosis Risk in Communities) study. Background: Questions remain after the JUPITER study, including whether the observed cardiovascular disease (CVD) event rates would persist with time and how these event rates would compare with other populations (lower hs-CRP and/or higher LDL-C levels). Methods: After stratification into 4 groups based on LDL-C and hs-CRP levels, with cutoffs at 130 mg/dl and 2.0 mg/l, respectively, incident CVD events were examined (mean follow-up, 6.9 years) and compared. Results: Of 8,907 age-eligible participants, 18.2% (n = 1,621) were JUPITER-eligible (hs-CRP ≥2.0 mg/l, LDL-C <130 mg/dl) and had an absolute CVD risk of ∼10.9% over a mean follow-up of 6.9 years (1.57% per year). If JUPITER hazard ratios were applied to this group, the number needed to treat to prevent 1 CVD event would be estimated at 38 over 5 years and 26 over 6.9 years. Conclusions: ARIC participants with elevated hs-CRP and low LDL-C had a CVD event rate of 1.57% per year over 6.9 years, similar to the CVD event rate noted in the JUPITER study placebo group (1.36% per year over 1.9 years). The association of hs-CRP ≥2.0 mg/l with increased CVD risk and mortality regardless of LDL-C provides us a simple method of using age and hs-CRP level for identifying higher risk individuals. (Atherosclerosis Risk in Communities study; NCT00005131).

Original languageEnglish (US)
Pages (from-to)2388-2395
Number of pages8
JournalJournal of the American College of Cardiology
Volume54
Issue number25
DOIs
StatePublished - 2009

Keywords

  • ARIC
  • LDL-C
  • cardiovascular disease
  • hs-CRP
  • lipids

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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