[JUPITER, what now?].

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.