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hsCRP reduces risk of heart disease

Achieving extremely low concentrations of LDL cholesterol and hsCRP can reduce risk of heart attack, stroke, or cardiovascular death by 79 per cent

According to a report on MedPage Today by Peggy Peck, executive editor, on March 29, healthy adults who achieved extremely low concentrations of LDL cholesterol and highly sensitive C-reactive protein (hsCRP) reduced their risk of heart attack, stroke, or cardiovascular death by 79 per cent. The hsCRP concentrations were also found to be independently predictive of outcome.

As Peck was reporting on findings from the JUPITER analysis, funded by AstraZeneca – marketers of rosuvastatin (Crestor), and presented by principal investigator, Dr Paul Ridker, at the American College of Cardiology meeting currently underway in Orlando, Florida. The findings were simultaneously published online in the Lancet.

15 548 men and women, with a mean age 66, no history of atherosclerosis, and a baseline cholesterol readings in the normal range (although they all had elevated hsCRP), participated in the JUPITER trial. The population profile was of people that were a little out-of-shape, with numbers nudging toward frank cardiovascular risk, but not meeting the current threshold for drug therapy. Subjects were randomised to assess the effects of rosuvastatin 20 mg versus placebo on rates of non-fatal myocardial infarction, non-fatal stroke, admission for unstable angina, arterial revascularisation, or cardiovascular death during a maximum follow-up of 5 years (median 1.9 years). Compared with those on placebo, participants randomised to rosuvastatin / Crestor who achieved an LDL of less than 70 mg/L had a 55 per cent reduction in vascular events, and those who achieved an hsCRP concentration of less than 2.0 mg/L had a 62 per cent reduction in events.

A 79 per cent reduction was noted in the 944 participants who achieved LDL cholesterol less than 1.8 mmol/L and hsCRP less than 1 mg/L,. Achieved hsCRP concentrations were predictive of event rates irrespective of the lipid endpoint used.

These results further earlier findings reported by Dr Ridker in November 2008 that less than two years of daily rosuvastatin therapy could reduce the relative risk of stroke, MI, and cardiovascular death by 44 per cent. "We now know that the large benefit gained is due not only to reduction in cholesterol, but to reduction in hsCRP as well," Dr Ridker states. 

30th March 2009

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