JUPITER Subanalysis: Reduction of LDL Determines Clinical Impact of Rosuvastatin Therapy

Original Title: Cholesterol treatment targets and clinical outcomes: a JUPITER trial update.
Presenter: Paul Ridker.

The lower the LDL cholesterol levels, the less adverse cardiovascular events in men and women initially healthy, according to an analysis of the JUPITER trial. Findings could help inform about the optimal LDL goals in primary prevention.

To explore the link between percent reduction of LDL and outcomes, Ridker and colleagues analyzed data from the JUPITER trial that included 17,802 patients initially healthy randomized to 20 mg of rosuvastatin (Crestor; AstraZeneca) or placebo, followed up through five years.

Median percent reduction in LDL cholesterol with rosuvastatin was 50%, despite the ample variability across the study population. A small proportion of patients saw no LDL reduction, half saw at least a 50% drop, and the rest, a smaller reduction.

The rate of first-ever MI, stroke, hospitalization for unstable angina requiring coronary intervention, or cardiovascular death (primary endpoint) per 1,000 person-years was 11.2 with placebo, 9.2 for those with no reduction in LDL cholesterol (RR 0.86), 6.7 for those with a less than 50% reduction (RR 0.61), and 4.8 for those with at least a 50% reduction (RR 0.41; P <0.00001 for trend).

The findings could be relevant now that PCSK9 inhibitors are emerging as a new class of lipid-lowering drugs. Patients with large reductions in LDL cholesterol on statins would see, in theory, less benefits with the new agents and those with smaller or no reductions would possibly have the most benefits.

More articles by this author

STEACS and the Use of Bivalirudin vs. Heparin: In Search of BRIGHT-4 Outcomes

Various studies and registries have previously shown the impact of post-percutaneous coronary intervention (PCI) complications on the survival of patients with ST-segment elevation acute...

TAVR and Atrial Fibrillation: What Anticoagulants Should We Use?

The prevalence of atrial fibrillation (AF) in TAVR patients ranges from 15 to 30%, depending on series. This arrhythmia has been associated to higher...

Ultrathin vs Thin-Strut Stents in PCI Patients at High Bleeding Risk

Several in vivo studies have shown that ultrathin stents present lower thrombogenic risk vs. thin-strut stents, which reflects in lower rates of target lesion...

Should We Withdraw Anticoagulation Before TAVR?

Approximately one-third of patients undergoing transcatheter aortic valve replacement (TAVR) have atrial fibrillation and are on oral anticoagulant (OAC) therapy. This creates a complex...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...