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Statin Cuts Cardiovascular Risk in Adults With High CRP, Without High Cholesterol

Rosuvastatin reduces cardiovascular events among adults who have elevated high-sensitivity C-reactive protein without high cholesterol, according to an industry-funded study released online by the New England Journal of Medicine.

Nearly 18,000 adults without hyperlipidemia (LDL below 130 mg/dL) but with elevated CRP (2 mg/L or higher) were randomized to rosuvastatin or placebo. The trial was stopped after roughly 2 years, when the rate of the primary endpoint — first major cardiovascular events (e.g., MI, stroke) — was lower with rosuvastatin than with placebo (0.77 vs. 1.36 events per 100 person-years).

Incident diabetes was more common with rosuvastatin.

Noting that absolute differences in risk are more meaningful than relative risk reductions when making treatment decisions, an editorialist points out that the proportion of patients with major cardiovascular events fell from 1.8% with placebo to 0.9% with rosuvastatin. With respect to high-sensitivity CRP testing, he concludes that "the evidence still favors" selective measurement in intermediate-risk patients.

LINK(S):

NEJM article (Free)

NEJM editorial (Free)

Journal Watch Cardiology summary (Free)

Recent Physician's First Watch coverage of study showing no link between genetically elevated CRP and cardiac risk (Free)

Published in Physician's First Watch November 10, 2008