Perna Gian Piero
Dipartimento di Scienze Cardiologiche Mediche e Chirurgiche, Struttura Complessa di Cardiologia G.M. Lancisi, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona.
G Ital Cardiol (Rome). 2009 Dec;10(11-12 Suppl 3):33S-38S.
The JUPITER study was conducted in apparently healthy, non-dyslipidemic subjects, but with high levels of high-sensitivity C-reactive protein (hsCRP), and showed a decrease in LDL cholesterol and hsCRP of 55% and 36%, respectively, with the administration of rosuvastatin at standard doses (20 mg/die), with a significant reduction in the incidence of major cardiovascular events. The event reduction was maximal in patients whose LDL cholesterol and hsCRP levels were lowered to < 70 mg/dl and <2 mg/I, respectively. The publication of the JUPITER data resulted in a wide debate within the international scientific community, particularly related to clinical implications of major findings. The main implications seem to be the confirmation of "the lower is better" philosophy and of the role of hsCRP as a marker to select, among intermediate risk subjects, patients who are actually at higher risk, who need to be treated with highly effective statins with a low side-effect profile, such as rosuvastatin. Patients with the "JUPITER phenotype" (metabolic syndrome + family history of cardiovascular disease) seem to benefit the most from a treatment that includes measurement of hsCRP and rosuvastatin administration.
JUPITER研究在表面健康、无血脂异常但高敏C反应蛋白（hsCRP）水平较高的受试者中进行，结果显示，标准剂量（20毫克/日）瑞舒伐他汀治疗可使低密度脂蛋白胆固醇和hsCRP水平分别降低55%和36%，主要心血管事件发生率显著降低。在低密度脂蛋白胆固醇和hsCRP水平分别降至<70毫克/分升和<2毫克/升的患者中，事件减少幅度最大。JUPITER研究数据的发表在国际科学界引发了广泛争论，尤其是关于主要研究结果的临床意义。主要意义似乎在于证实了“越低越好”的理念，以及hsCRP作为一种标志物在选择中度风险受试者中实际处于较高风险、需要用副作用小的高效他汀类药物（如瑞舒伐他汀）进行治疗的患者方面的作用。具有“JUPITER表型”（代谢综合征+心血管疾病家族史）的患者似乎从包括测量hsCRP和使用瑞舒伐他汀的治疗中获益最大。
