Are Cardiovascular Benefits in Statin Lipid Effects Dependent on Baseline Lipid Levels?
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Keith C. Ferdinand
- چاپ و سال / کشور: 2010
Description
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
Curr Atheroscler Rep (2011) 13:64–72 DOI 10.1007/s11883-010-0149-9 Published online: 23 November 2010
