News | September 02, 2010

Intermediate Risk Patients Benefit From Statin Therapy

September 2, 2010 - Women and men with a 10-year cardiovascular disease risk of 5 percent or more and normal cholesterol levels but high levels of hsCRP, a protein associated with inflammation, could reduce their risk substantially with statin therapy, according to new research.

The study, published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, is a new analysis of data from the randomized, placebo-controlled, double blind Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER). The study included men age 50 or older and women age 60 or older.

For patients with elevated high sensitivity C-reactive protein (hsCRP) – a protein associated with systemic inflammation – the study found that taking cholesterol-lowering statin drugs could:

• Reduce the relative risk of cardiovascular disease (CVD) by 45 percent for people estimated to have a 10-year CVD risk of 5 percent to 10 percent; and
• Reduce the relative risk by 49 percent among those with an estimated 11 percent to 20 percent 10-year risk.

"These data demonstrate that women and men with elevated hsCRP who are otherwise at 5 percent to 20 percent 10-year risk had substantive risk reductions with statin therapy even though they are currently outside United States treatment guidelines," said Paul Ridker, M.D., lead study author and director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital, Boston. Ridker is also principal investigator of JUPITER.

People with a 10-year risk of less than 5 percent did not have a statistically significant reduction in events with statins.
He said recent changes in Canadian prevention guidelines prompted a need to better define CVD risk. The new Canadian recommendations call for statin therapy for patients who have "intermediate risk" – defined as 10 percent to 19 percent 10-year risk – and elevated hsCRP, even if their cholesterol levels are in the normal range (i.e. LDL-cholesterol below 130 mg/dL).

"The new Canadian guidelines are a major step forward for prevention and incorporate hsCRP in a thoughtful manner," Ridker said. "However, intermediate risk was defined in the Canadian guidelines as 10 to 20 percent 10-year risk, yet we observed major benefits of statin therapy for those with risks of 5 to 10 percent as well." He added that many physicians incorrectly consider a 5 percent to 10 percent risk score to be "low-risk," especially in women who tend to develop CVD at least a decade later than men, although heart and blood vessel disease remains the number one killer of women and men.

Risk is calculated with screening tools, such as the Framingham Risk Score, which predicts CVD risk based on traditional risk factors such as age, gender, smoking, blood pressure and cholesterol; or the Reynolds Risk Score which also considers hsCRP and parental history of premature heart disease.

The current study finds that although men and women in the 5 percent to 10 percent Framingham 10-year risk group get equal benefit from statin therapy, more women tend to be in the 5 percent to 10 percent risk group while men tend to be in the 11 to 20 percent group.

These data also support the current position taken by the American Heart Association and the U.S. Centers for Disease Control that hsCRP testing is best used in people with intermediate risk to help doctors in their treatment decisions. Statins are known to reduce levels of both cholesterol and hsCRP. In addition, he said statin therapy is no substitute for a healthy diet, smoking cessation and exercise.

"This analysis of the JUPITER study provides important information indicating the groups of men and women who have high CRP and normal LDL-cholesterol that could benefit from statin treatment," said Pamela Ouyang, M.D., professor of medicine at Johns Hopkins University and an American Heart Association volunteer. "The statin used in the JUPITER study was rosuvastatin at a dose of 20 mg. The degree of lowering in risk that would be obtained using lower doses or less potent statin therapy is not known."

For more information: www.americanheart.org, corporatefunding

Related Content

Bivalirudin exhibited an improvement in 30-day all-cause mortality when injected post PCI.
News | Antiplatelet and Anticoagulation Therapies| August 16, 2017
August 16, 2017 — A study has examined the efficacies of various post-percutaneous coronary intervention (PCI) bivali
ESC 2017 late breaking trial hot line study presentations.
News | Clinical Study| August 16, 2017
Aug. 16, 2017 – The European Society of Cardiology (ESC) Congress 2017 includes several Hot Line Late-breaking Clinic
News | Drug-Eluting Balloons| August 15, 2017
Surmodics Inc. announced receipt of an investigational device exemption (IDE) from the U.S. Food and Drug...
The Vascular Dynamics MobiusHD device enhances the carotid baroreceptors to reduce resistant hypertension.
News | Hypertension| August 15, 2017
Aug. 15, 2017 — The U.S. Food and Drug Administration (FDA) has approved the Vascular Dynamics Inc.
Abbott Initiates First Clinical Trial of Clip-Based Tricuspid Repair System
News | Heart Valve Technology| August 09, 2017
Abbott announced that the first patient has been enrolled in a clinical study to evaluate a minimally invasive clip-...
Three New Atrial Fibrillation Studies to Feature HeartLight Endoscopic Ablation System
News | Ablation Systems| August 07, 2017
CardioFocus Inc. announced that its HeartLight Endoscopic Ablation System is being featured in three new major clinical...
Registry Identifies Early Onset of Heart Failure and Lack of Defibrillators in Asia
News | Heart Failure| August 03, 2017
August 3, 2017 — The Asian Pacific Society of Cardiology (ASPC) held its first-ever late-breaking...
New Study Focuses on Protein Responsible For Increased Heart Disease Risk
News | Cardiac Diagnostics| August 03, 2017
August 3, 2017 — A study to reduce the strongest inherited...
Overlay Init