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Published on: November 10, 2017
Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease
Salim Yusuf1, Jackie Bosch1, Gilles Dagenais1
1From the Population Health Research Institute, Hamilton Health Sciences (S.Y., J.B., R.M., J.P., H.J., P.G., E.L.), Departments of Medicine (S.Y., R.M., E.L.) and Clinical Epidemiology and Biostatistics (J.P.), and School of Rehabilitation Science (J.B.), McMaster University, Hamilton, ON, Institut Universitaire de Cardiologie et Pneumologie de Québec, Université Laval, Quebec, QC (G.D.), and Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto (L.A.L.) - all in Canada; Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (J.Z., L.L.); St. John's Medical College (D.X.) and St. John's Research Institute (D.X., P.P.), Bangalore, India; Fundacion Oftalmológica de Santander and Instituto Masira, Medical School, Universidad de Santander, Bucaramanga (P.L.-J.), and University of Quindio, Armenia (G.S.-V.) - both in Colombia; College of Medicine, University of the Philippines, Manila (A.D.); Dante Pazzanese Institute of Cardiology (A.A.) and HCor-Heart Hospital (L.S.P.), São Paulo; Institute of Cardiology, Kiev, Ukraine (A.P.); Hungarian Institute of Cardiology, Semmelweis University, Budapest (K. Keltai, M.K.); Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Soweto Cardiovascular Research Group, Cape Town, South Africa (K.S.); Department of Cardiology, Academic Medical Center, Amsterdam (R.J.G.P); Department of Medical Sciences, Cardiology, Clinical Research Center, Uppsala University, Uppsala, Sweden (C.H.); Institute of Clinical Cardiology in the Russian Cardiology Research Complex, Moscow (I.C.); Universiti Teknologi Majlis Amansh Rakyat, Selayang, and University College Sedaya International University, Kuala Lumpur - both in Malaysia (K.Y.); Lady Davis Carmel Medical Center, Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa (B.S.L.); Universi
Rosuvastatin significantly reduces cardiovascular events in intermediate-risk diverse populations. This cholesterol-lowering statin therapy is effective for primary prevention, demonstrating broad applicability beyond high-risk groups.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Previous trials established statin benefits for cardiovascular event reduction in high-risk individuals.
- Gaps existed regarding statin efficacy in intermediate-risk, ethnically diverse populations without pre-existing cardiovascular disease.
Purpose of the Study:
- To evaluate the effectiveness of rosuvastatin in reducing cardiovascular events in an intermediate-risk, ethnically diverse population without cardiovascular disease.
Main Methods:
- A 2x2 factorial trial randomized 12,705 participants to rosuvastatin (10 mg/day) or placebo.
- Coprimary outcomes included cardiovascular death, myocardial infarction, stroke, revascularization, heart failure, and cardiac arrest.
- Median follow-up was 5.6 years across 21 countries.
Main Results:
- Rosuvastatin lowered low-density lipoprotein cholesterol by 26.5% compared to placebo.
- A significant reduction in the first coprimary outcome (cardiovascular death, MI, stroke) was observed (3.7% vs. 4.8%; HR 0.76, P=0.002).
- Results were consistent across subgroups; increased cataract surgery and muscle symptoms were noted with rosuvastatin.
Conclusions:
- Rosuvastatin (10 mg/day) significantly lowers cardiovascular event risk in intermediate-risk, ethnically diverse individuals.
- The findings support the use of statins for primary cardiovascular event prevention in broader populations.
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