BackgroundIncreased levels of the inflammatory biomarker high-sensitivity C-reactive proteinpredict cardiovascular events. Since statins lower levels of high-sensitivity C-reactiveprotein as well as cholesterol, we hypothesized that people with elevated high-sensitivityC-reactive protein levels but without hyperlipidemia might benefit from statintreatment.MethodsWe randomly assigned 17,802 apparently healthy men and women with low-densitylipoprotein (LDL) cholesterol levels of less than 130 mg per deciliter (3.4 mmol perliter) and high-sensitivity C-reactive protein levels of 2.0 mg per liter or higher torosuvastatin, 20 mg daily, or placebo and followed them for the occurrence of thecombined primary end point of myocardial infarction, stroke, arterial revascularization,hospitalization for unstable angina, or death from cardiovascular causes.ResultsThe trial was stopped after a median follow-up of 1.9 years (maximum, 5.0). Rosuvastatinreduced LDL cholesterol levels by 50% and high-sensitivity C-reactive proteinlevels by 37%. The rates of the primary end point were 0.77 and 1.36 per 100 person-years of follow-up in the rosuvastatin and placebo groups, respectively (hazardratio for rosuvastatin, 0.56; 95% confidence interval [CI], 0.46 to 0.69; P<0.00001), withcorresponding rates of 0.17 and 0.37 for myocardial infarction (hazard ratio, 0.46; 95%CI, 0.30 to 0.70; P = 0.0002), 0.18 and 0.34 for stroke (hazard ratio, 0.52; 95% CI, 0.34 to0.79; P = 0.002), 0.41 and 0.77 for revascularization or unstable angina (hazard ratio,0.53; 95% CI, 0.40 to 0.70; P<0.00001), 0.45 and 0.85 for the combined end point ofmyocardial infarction, stroke, or death from cardiovascular causes (hazard ratio, 0.53;95% CI, 0.40 to 0.69; P<0.00001), and 1.00 and 1.25 for death from any cause (hazardratio, 0.80; 95% CI, 0.67 to 0.97; P = 0.02). Consistent effects were observed in all subgroupsevaluated. The rosuvastatin group did not have a significant increase in myopathyor cancer but did have a higher incidence of physician-reported diabetes.ConclusionsIn this trial of apparently healthy persons without hyperlipidemia but with elevatedhigh-sensitivity C-reactive protein levels, rosuvastatin significantly reduced the incidenceof major cardiovascular events.
การแปล กรุณารอสักครู่..
