Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 54, Issue 25, Pages 2388-2395Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2009.10.006
Keywords
hs-CRP; LDL-C; ARIC; lipids; cardiovascular disease
Categories
Funding
- National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Maryland [N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, N01-HC-55022]
- Abbott
- AstraZeneca
- GlaxoSmithKline
- Merck
- Sanofi-Synthelabo
- Schering-Plough
- Takeda
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Objectives The purpose of this study is to describe the proportion of JUPITER-eligible (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin) individuals and clinical outcomes of individuals based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C) strata in the ARIC (Atherosclerosis Risk in Communities) study. Background Questions remain after the JUPITER study, including whether the observed cardiovascular disease (CVD) event rates would persist with time and how these event rates would compare with other populations (lower hs-CRP and/or higher LDL-C levels). Methods After stratification into 4 groups based on LDL-C and hs-CRP levels, with cutoffs at 130 mg/dl and 2.0 mg/l, respectively, incident CVD events were examined (mean follow-up, 6.9 years) and compared. Results Of 8,907 age-eligible participants, 18.2% (n = 1,621) were JUPITER-eligible (hs-CRP >= 2.0 mg/l, LDL-C <130 mg/dl) and had an absolute CVD risk of similar to 10.9% over a mean follow-up of 6.9 years (1.57% per year). If JUPITER hazard ratios were applied to this group, the number needed to treat to prevent 1 CVD event would be estimated at 38 over 5 years and 26 over 6.9 years. Conclusions ARIC participants with elevated hs-CRP and low LDL-C had a CVD event rate of 1.57% per year over 6.9 years, similar to the CVD event rate noted in the JUPITER study placebo group (1.36% per year over 1.9 years). The association of hs-CRP >= 2.0 mg/l with increased CVD risk and mortality regardless of LDL-C provides us a simple method of using age and hs-CRP level for identifying higher risk individuals. (Atherosclerosis Risk in Communities study; NCT00005131) (J Am Coll Cardiol 2009; 54: 2388-95) (C) 2009 by the American College of Cardiology Foundation
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