The JUPITER trial: How will it change clinical practice?

Area of Science:

• Cardiology
• Preventive Medicine
• Biomarkers

Background:

• Baseline high-sensitivity C-reactive protein (hs-CRP) levels predict future cardiovascular events in healthy individuals.
• Elevated hs-CRP may identify patients who could benefit from primary prevention statin therapy.

Purpose of the Study:

• To evaluate rosuvastatin's efficacy in reducing cardiovascular events in apparently healthy individuals with low LDL-C but elevated hs-CRP.
• To determine if statin therapy benefits individuals identified by hs-CRP, irrespective of LDL-C levels.

Main Methods:

• The JUPITER trial randomized participants with LDL-C < 130 mg/dL and hs-CRP ≥ 2 mg/L to rosuvastatin 20 mg/d or placebo.
• Primary composite endpoint included nonfatal myocardial infarction, stroke, arterial revascularization, or cardiovascular death.

Main Results:

• Rosuvastatin significantly reduced the primary composite endpoint by 44% compared to placebo.
• The benefit of rosuvastatin was observed across the study population, irrespective of baseline LDL-C levels.

Conclusions:

• Elevated hs-CRP levels identify individuals who benefit from statin therapy for primary cardiovascular event prevention.
• Rosuvastatin therapy is effective in reducing cardiovascular events in apparently healthy individuals with elevated hs-CRP and low LDL-C.