Related Experiment Videos
Eligibility for statin therapy by the JUPITER trial criteria and subsequent mortality
Mary Cushman1, Leslie A McClure, Susan G Lakoski
1Department of Medicine, University of Vermont, Burlington, Vermont, USA. mary.cushman@uvm.edu
Insights
The JUPITER trial criteria identified 21% of individuals not previously eligible for statin therapy. Elevated C-reactive protein (CRP) in these individuals was linked to a 1.5-fold increased risk of total mortality.
Area of Science:
- Cardiovascular Medicine
- Preventive Cardiology
- Clinical Trials
Background:
- The Justification for the Use of Statins in Primary Prevention: An Intervention Trial Using Rosuvastatin (JUPITER) trial demonstrated benefits of statin therapy in patients with elevated C-reactive protein (CRP) and average cholesterol.
- Existing guidelines for lipid-lowering treatment eligibility may not encompass all individuals who could benefit from statins.
Purpose of the Study:
- To determine the prevalence of eligibility for statin treatment using JUPITER criteria in a general population.
- To assess mortality rates among individuals eligible for statin treatment based on JUPITER criteria.
Main Methods:
- Analysis of 30,229 participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
- Identification of participants aged >= 45 years, without vascular diagnoses or prior lipid-lowering treatment, meeting JUPITER entry criteria (elevated CRP and average cholesterol).
- Follow-up for mortality over 3.5 years.
Main Results:
- Among 11,339 eligible participants, 21% met JUPITER entry criteria.
- Eligible REGARDS participants had similar low-density lipoprotein cholesterol and CRP levels to JUPITER participants but were more often women, Black, had metabolic syndrome, and used aspirin.
- Mortality rate in JUPITER-eligible REGARDS participants was 1.17 per 100 patient-years.
- Individuals with CRP levels >= 2 mg/L had a 1.5-fold increased risk of total mortality compared to those with CRP < 2 mg/L.
Conclusions:
- A significant proportion (21%) of individuals not meeting existing guidelines would be newly eligible for statin therapy based on JUPITER trial criteria.
- Elevated CRP in this population is associated with increased total mortality, highlighting potential benefits of statin intervention.
- These findings suggest a broader application of statin therapy for primary prevention in individuals with elevated CRP.
Abstract:
Justification for the Use of Statins in Primary Prevention: An Intervention Trial Using Rosuvastatin (JUPITER) reported reduced cardiovascular and all-cause mortality with statin treatment in patients with elevated C-reactive protein (CRP) and average cholesterol levels who were not eligible for lipid-lowering treatment on the basis of existing guidelines. The aim of this study was to determine the prevalence of eligibility and mortality in a general population sample on the basis of eligibility for statin treatment using the JUPITER criteria. The study group consisted of 30,229 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, an observational study of US African American and white participants aged > or =45 years, enrolled in their homes from 2003 to 2007 and followed biannually by telephone. Among 11,339 participants age eligible for JUPITER and without vascular diagnoses or using lipid-lowering treatment, 21% (n = 2,342) met JUPITER entry criteria. Compared with JUPITER participants, they had similar low-density lipoprotein cholesterol and CRP levels, were more often women, were more often black, had metabolic syndrome, and used aspirin for cardioprotection. Over 3.5 years of follow-up, the mortality rate in REGARDS participants eligible for JUPITER was 1.17 per 100 patient-years (95% confidence interval 0.94 to 1.42). Compared with those otherwise JUPITER eligible who had CRP levels <2 mg/L (n = 2,620), those with CRP levels > or =2 mg/L had a multivariate-adjusted relative risk of 1.5 (95% confidence interval 1.1 to 2.2) for total mortality. In conclusion, 21% not otherwise eligible would be newly eligible for lipid lowering treatment on the basis of JUPITER trial eligibility.
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:26Atherosclerosis III: Management
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
01:11Clinical Trials: Overview