Document Detail


Are cardiovascular benefits in statin lipid effects dependent on baseline lipid levels?
MedLine Citation:
PMID:  21104458     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Statins reduce coronary heart disease (CHD) morbidity and mortality over a wide range of patients. The Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) in subjects with elevated C-reactive protein, without vascular disease and below average low-density lipoprotein cholesterol (LDL-C) showed a 50% reduction in LDL-C with 20 mg/d of rosuvastatin and a reduction in cardiovascular events (hazard ratio 0.56 [95% CI, 0.46-0.69]; P < 0.00001), and a reduction in total mortality (20%; P < 0.02). Recent commentary has criticized perceived JUPITER design flaws and inappropriate influence. However, the Canadian 2009 guidelines cite JUPITER as class I evidence for statin benefit. Although the Cholesterol Treatment Trialists' (CTT) Collaborators showed that, regardless of pre-treatment levels, statins can significantly reduce CHD, major vascular events, and overall mortality, a recent primary prevention meta-analysis showed no decrease in all-cause mortality. Preconceived notions on statin benefit or harm do not enhance patient care and clinicians should individualize long-term statin therapy.
Authors:
Keith C Ferdinand
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current atherosclerosis reports     Volume:  13     ISSN:  1534-6242     ISO Abbreviation:  Curr Atheroscler Rep     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897685     Medline TA:  Curr Atheroscler Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  64-72     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Emory University, 5355 Hunter Rd., Atlanta, GA 30349, USA. kferdinand@abcardio.org
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