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A statin for healthy people?
A statin known as Crestor has been shown to almost halve deaths from heart attack and stroke among apparently healthy patients
The increased risk of heart attack and stroke for patients with high levels of 'bad' LDL cholesterol is well known, and often treated with a class of cholesterol-lowering drugs known as statins.
Now the Jupiter (the 'Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin') study funded by AstraZeneca, the makers of Crestor (rosuvastatin), has been tested on patients who don't have high cholesterol, but do have increased levels of a c-reactive protein called hsCRP, that indicates inflammation in the body and is linked to an increased risk of heart disease.
At a meeting of the American Heart Association in Chicago, researchers from the Brigham and Women's Hospital in Boston, Massachussetts, who carried out the study, revealed that among the 17,802 men and women in the trial, those who were given daily doses of Crestor experienced a 54 per cent reduction in heart attack, a 48 per cent reduction in stroke, a 46 per cent reduction in need for angioplasty or bypass surgery, and a 20 per cent reduction in all-cause mortality, compared to participants who were given a placebo.
There was no difference between treatment groups for major adverse events, including cancer or myopathy, but as in almost all prior statin trials, there was a small increase in reported diabetes. Their findings will be published in the New England Journal of Medicine.
"Our results are relevant for patient care and the prevention of heart attack and stroke," said Paul Ridker, MD, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital and lead author of the study. "Physicians can no longer assume that patients are at low risk for heart disease simply because they have low cholesterol. We have confirmed that patients with increased hsCRP are at high risk even if cholesterol levels are low, and we now have evidence that a simple and safe therapy cuts that risk and saves lives."
Work prior to Jupiter established that patients with increased hsCRP were at high risk of heart disease, despite lacking other conventional risk factors, and that statins lower hsCRP levels, indicating anti-inflammatory as well as cholesterol-lowering effects. Until Jupiter, however, whether statin treatment would reduce cardiac events among these patients had been uncertain.
Professor Peter Weissberg, Medical Director at the British Heart Foundation said: "The Jupiter study is the first to show that the most potent and recently introduced statin - rosuvastatin - reduces heart attacks and save lives, even in people whose cholesterol is not raised.
"It strongly supports the 'lower is better' approach to cholesterol management. However, further studies are required to determine if measuring c-reactive protein is the right way to identify people likely to gain most from treatment.
"Importantly, rosuvastatin treatment was associated with a very low incidence of myopathy, the commonest side effect of statins.
"The Jupiter findings raise questions about who should receive treatment to prevent a heart attack, how aggressively they should be treated and with which drug. These important issues have profound implications for future NICE guidelines.
"This research, adds to the body of evidence that statins work, and that the lower your cholesterol level, the lower your risk of a heart attack or stroke."
Useful articles
- What's your risk of stroke?
- What's your risk of heart disease?
- What you need to know about cholesterol
- Mediterranean diet lowers heart disease risk
- An introduction to statins
- The Saga health calculator
- Heart disease gene found
- Statins: the case for and against
- Common gene variant explains rare statin side effect
- Western diet raises heart attack risk
- Questions you need to ask your doctor about heart conditions
- Cholesterol: can you lower yours?
- Statin may cut blood pressure
- Chat about health at Saga Zone
Information on this site is for interest only and is not a substitute for professional medical advice. You should consult your own doctor about any specific health concerns.
