Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, Texas, USA.
J Am Coll Cardiol. 2009 Dec 15;54(25):2388-95. doi: 10.1016/j.jacc.2009.10.006.
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.
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).
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.
Of 8,907 age-eligible participants, 18.2% (n = 1,621) were JUPITER-eligible (hs-CRP > or = 2.0 mg/l, LDL-C <130 mg/dl) and had an absolute CVD risk of approximately 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.
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 > or = 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).
本研究旨在描述基于高敏 C 反应蛋白（hs-CRP）和低密度脂蛋白胆固醇（LDL-C）分层的 ARIC（社区动脉粥样硬化风险）研究中“JUPITER 合格”（他汀类药物预防的正当性：评估瑞舒伐他汀的干预试验）个体的比例和临床结局。
JUPITER 研究后仍存在一些问题，包括观察到的心血管疾病（CVD）事件发生率是否会随着时间的推移而持续，以及这些事件发生率与其他人群（hs-CRP 较低和/或 LDL-C 较高）相比如何。
根据 LDL-C 和 hs-CRP 水平分层为 4 组，分别以 130mg/dl 和 2.0mg/L 为切点，观察（平均随访 6.9 年）和比较新发 CVD 事件。
在 8907 名符合年龄要求的参与者中，18.2%（n=1621）为 JUPITER 合格者（hs-CRP≥2.0mg/L，LDL-C＜130mg/dl），平均随访 6.9 年，绝对 CVD 风险约为 10.9%（每年 1.57%）。如果将 JUPITER 风险比应用于该组，估计预防 1 例 CVD 事件需要治疗的人数为 5 年内 38 人，6.9 年内 26 人。
ARIC 参与者 hs-CRP 升高且 LDL-C 较低，6.9 年内 CVD 事件发生率为 1.57%/年，与 JUPITER 研究安慰剂组 1.9 年内 1.36%/年的 CVD 事件发生率相似。hs-CRP≥2.0mg/L 与 CVD 风险增加和死亡率相关，无论 LDL-C 水平如何，这为我们提供了一种使用年龄和 hs-CRP 水平识别高风险个体的简单方法。（社区动脉粥样硬化风险研究；NCT00005131）。
