Thursday, August 12, 2010
cholesterol HDL
The JUPITER study previously found that rosuvastatin could significantly improve cardiovascular and other outcomes among adults with LDL cholesterol levels less than 130 mg/dL but with high-sensitivity C-reactive protein levels of 2 mg/L or higher. In a previous analysis by Ridker and colleagues, which was published in the November 20, 2008, issue of the New England Journal of Medicine, rosuvastatin 20 mg daily reduced the risk for myocardial infarction by 54% vs placebo. In addition, rosuvastatin significantly reduced the risk for stroke by 48% and all-cause mortality by 20%.
HDL cholesterol level has been inversely related to the risk for cardiovascular disease, but previous research has questioned whether treatment with statins obviates the higher risk for cardiovascular events associated with low HDL cholesterol levels. The current analysis of the JUPITER study addresses this issue.
Study Highlights
* Patients with diabetes or previous cardiovascular disease were excluded from the JUPITER cohort.
* Participants were randomly assigned to receive rosuvastatin 20 mg daily or placebo.
* The aim of the current study was to determine the relative impact of HDL cholesterol and apolipoprotein A1 levels on the risk for a primary cardiovascular endpoint among participants receiving rosuvastatin or placebo. The primary cardiovascular endpoint included myocardial infarction, stroke, unstable angina, a revascularization procedure, or cardiovascular death.
* 17,802 individuals participated in the study. The mean age of subjects was 66 years, and 38% of participants were women.
* Rosuvastatin treatment raised HDL cholesterol concentrations by an average of 4% vs placebo. Rosuvastatin significantly improved cardiovascular outcomes among participants divided into quartiles based on their baseline HDL cholesterol levels.
* Among participants receiving placebo, the lowest quartile of HDL cholesterol concentration experienced a 46% increase in the risk for cardiovascular events vs the highest quartile.
* However, the same was not true among participants receiving rosuvastatin. The risk for cardiovascular events was similar regardless of HDL quartile among these individuals.
* Similarly, the risk for cardiovascular events was inversely related to the concentration of apolipoprotein A1 among participants in the placebo group but not in the rosuvastatin group.
Clinical Implications
* In the JUPITER study, the use of rosuvastatin reduced the risks for myocardial infarction, stroke, and overall mortality vs placebo among patients with a normal LDL cholesterol level but an elevated high-sensitivity C-reactive protein level.
* The current study demonstrates that HDL cholesterol and apolipoprotein A1 concentrations may not be significant in predicting the risk for cardiovascular events among patients already receiving high-dose statin therapy.
HDL cholesterol level has been inversely related to the risk for cardiovascular disease, but previous research has questioned whether treatment with statins obviates the higher risk for cardiovascular events associated with low HDL cholesterol levels. The current analysis of the JUPITER study addresses this issue.
Study Highlights
* Patients with diabetes or previous cardiovascular disease were excluded from the JUPITER cohort.
* Participants were randomly assigned to receive rosuvastatin 20 mg daily or placebo.
* The aim of the current study was to determine the relative impact of HDL cholesterol and apolipoprotein A1 levels on the risk for a primary cardiovascular endpoint among participants receiving rosuvastatin or placebo. The primary cardiovascular endpoint included myocardial infarction, stroke, unstable angina, a revascularization procedure, or cardiovascular death.
* 17,802 individuals participated in the study. The mean age of subjects was 66 years, and 38% of participants were women.
* Rosuvastatin treatment raised HDL cholesterol concentrations by an average of 4% vs placebo. Rosuvastatin significantly improved cardiovascular outcomes among participants divided into quartiles based on their baseline HDL cholesterol levels.
* Among participants receiving placebo, the lowest quartile of HDL cholesterol concentration experienced a 46% increase in the risk for cardiovascular events vs the highest quartile.
* However, the same was not true among participants receiving rosuvastatin. The risk for cardiovascular events was similar regardless of HDL quartile among these individuals.
* Similarly, the risk for cardiovascular events was inversely related to the concentration of apolipoprotein A1 among participants in the placebo group but not in the rosuvastatin group.
Clinical Implications
* In the JUPITER study, the use of rosuvastatin reduced the risks for myocardial infarction, stroke, and overall mortality vs placebo among patients with a normal LDL cholesterol level but an elevated high-sensitivity C-reactive protein level.
* The current study demonstrates that HDL cholesterol and apolipoprotein A1 concentrations may not be significant in predicting the risk for cardiovascular events among patients already receiving high-dose statin therapy.
# posted by roodbont @ 1:25 AM 
