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Rosuvastatin Reduces Risk of Death in Patients With CKD, Elevated C-Reactive Protein: Presented at ACC By Ed Susman ATLANTA -- March 18, 2010 -- Patients with chronic kidney disease (CKD) who have low levels of cholesterol but elevated C-reactive protein appear to markedly reduce their risk of mortality when treated with rosuvastatin, researchers said here at the 59th Annual Scientific Sessions of the American College of Cardiology (ACC). A substudy of the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) trial illustrated that, when compared with placebo, patients on rosuvastatin achieved a 44% reduction in death. In JUPITER, more than 18,000 participants with low levels of low-density lipoprotein cholesterol but with elevated levels of C-reactive protein were treated with either rosuvastatin 20 mg or a placebo. In the subset analysis, Paul Ridker, MD, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, and colleagues identified 3,267 patients with CKD (estimated glomerular filtration rate [eGFR] <60 mL/minute/1.73 m2). When they analysed outcomes among these patients, the researchers observed that the patients taking rosuvastatin achieved the following: · A 45% reduction in the risk of experiencing 1 of the primary endpoints in the study -- myocardial infarction (MI), stroke, hospitalisation for unstable angina, the need for arterial revascularisation, or confirmed cardiovascular death (P = .002). · A 44% reduction in all-cause mortality (P = .005). “I really don’t know why we saw these reductions in events among these patients,” Dr. Ridker said during his poster presentation on March 14. “I just know what these outcomes show.” The improvement occurred even though there was a marginal improvement in eGFR among all patients assigned to rosuvastatin in the trial after 12 months of treatment. The researchers suggested that results of the subset analysis “support guidelines from the American Heart Association and the National Kidney Foundation to provide more aggressive cardiovascular prevention efforts among those with reduced renal function.” Dr. Ridker noted that, overall, patients with CKD had a 54% increased risk of experiencing an endpoint event. Among those with moderate kidney disease at study entry, 71 patients assigned to placebo experienced 1 of the defining events in the study, compared with 40 patients with CKD who were assigned to rosuvastatin. Dr. Ridker said the secondary analysis of the JUPITER study among patients with CKD was prompted by previous studies that had given rise to questions about whether statins should be used in this patient population. In fact, Dr. Ridker noted that the absolute reductions in risk of experiencing an endpoint event was greater among those with eGFR <60 mL/minute/1.73 m2 than patients with rates >=60 mL/minute/1.73 m2, although both groups appeared to benefit. Funding for this study was provided by AstraZeneca. [Presentation title: Efficacy of Rosuvastatin Among Men and Women With Chronic Kidney Disease and Elevated hsCRP: The JUPITER Trial. Abstract 1077-117] E-mail this page to a friend or colleague! To print, use this version