Statins May Provide Benefit Despite Low LDL

Patients with low cholesterol and high C-reactive protein may still benefit from statins
By A. Agrawal, PhD
HealthDay Reporter

TUESDAY, Dec. 15 (HealthDay News) -- Based on data from an earlier trial, individuals with low levels of low-density lipoprotein cholesterol (LDL-C) and high levels of high-sensitivity C-reactive protein (hs-CRP) may benefit from statins to reduce the incidence of cardiovascular disease, according to a study in the Dec. 15/22 issue of the Journal of the American College of Cardiology.

Eric Y. Yang, M.D., of the Baylor College of Medicine in Houston, and colleagues stratified 5,513 older individuals without cardiovascular disease into four groups based on levels of LDL-C and hs-CRP. One of the four groups (1,621 individuals, 18.2 percent) had LDL-C less than 130 mg/dL and hs-CRP of 2.0 mg/L or more, which was the eligibility criteria for the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) that had previously shown that rosuvastatin could reduce cardiovascular events.

After a median follow-up of 6.9 years, the researchers found that the JUPITER-eligible group had a rate of major adverse cardiovascular events of 15.73 per 1,000 person-years, similar to the JUPITER placebo group, and an absolute risk of cardiovascular disease of 10.9 percent. Applying the reduction in events from rosuvastatin treatment in the JUPITER trial, they estimated that 38 individuals would have to be treated to prevent one cardiovascular disease event over five years.

"The association of hs-CRP of ≥2.0 mg/L with increased cardiovascular disease risk and mortality regardless of LDL-C provides us a simple method of using age and hs-CRP level for identifying higher risk individuals," the authors conclude.

Several authors reported financial and consulting relationships with pharmaceutical companies.

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