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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EEvidence from the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin [JUPITER; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00239681\u0026amp;atom=%2Fspmdc%2F9%2F1%2F11.atom\u0022\u003ENCT00239681\u003C\/a\u003E] trial [Ridker PM et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2008] provides support for the use of statins to prevent strokes in healthy individuals with low LDL cholesterol but elevated high-sensitivity C-reactive protein levels.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENeurology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELipid Disorders\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECerebrovascular Disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EEvidence from the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00239681\u0026amp;atom=%2Fspmdc%2F9%2F1%2F11.atom\u0022\u003ENCT00239681\u003C\/a\u003E) trial [Ridker PM et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2008] provides support for the use of statins to prevent strokes in healthy individuals with low LDL cholesterol but elevated high-sensitivity C-reactive protein (hsCRP) levels. Robert Glynn, PhD, Brigham and Women\u0027s Hospital, Boston, MA, presented results that showed that rosuvastatin (20 mg\/day) reduced the incidence of stroke by 48% after 1 year of treatment compared with placebo (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). The benefits occurred across all subgroups, including patients at higher risk, with no evidence of an increased risk for hemorrhagic stroke.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/1\/11\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Cumulative Incidence of Venous Thromboembolism.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1076909487\u0022 data-figure-caption=\u0022Cumulative Incidence of Venous Thromboembolism.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/1\/11\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/1\/11\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/1\/11\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11386\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-3\u0022 class=\u0022first-child\u0022\u003ECumulative Incidence of Venous Thromboembolism.\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003ECopyright\u00a9 2009 Massachusetts Medical Society. All rights reserved.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-4\u0022\u003EAlthough lipid levels are significant risk determinants for ischemic stroke and coronary vascular disease (CVD), several studies have shown that individuals with high levels of hsCRP are at increased risk for stroke [Rost NS et al. \u003Cem\u003EStroke\u003C\/em\u003E 2001; Ballantyne CM et al. \u003Cem\u003EArch Intern Med\u003C\/em\u003E 2005; Everett B et al. \u003Cem\u003EJACC\u003C\/em\u003E 2006]. The objective of this study was to determine if rosuvastatin would reduce stroke rates among individuals with low levels of cholesterol but elevated levels of hsCRP.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EJUPITER enrolled 17,802 apparently healthy men and women at 1315 sites in 26 countries. Patients were required to have LDL levels \u0026lt;130 mg\/dL and hsCRP levels \u0026gt;2.0 mL, be aged \u226550 years (men) or \u226560 years (women), and have no CVD or diabetes. The primary endpoint was the first major cardiovascular event (nonfatal myocardial infarction, nonfatal stroke, arterial revascularization, hospitalization for unstable angina, or cardiovascular death).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EMedian age of the study population was 66 years; 38% was women; 12% was black and 12% was Hispanic; mean blood pressure was 134\/80 mm Hg; 16% smoked; and 17% used aspirin. After 12 months, rosuvastatin reduced LDL cholesterol levels by 50% (sustained for the course of the trial), hsCRP by 37% (sustained), triglycerides by 17%, and HDL by 4% compared with placebo.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe trial was stopped after a median follow-up of 1.9 years, because a significant (p\u0026lt;0.00001) change in the HR (0.56; 95% CI, 0.46 to 0.69) of the primary endpoint was reached. Overall, rosuvastatin was associated with a 44% reduction in the composite endpoint. There were 33 stroke events in the rosuvastatin group and 64 in the placebo group, a 48% reduction in HR (0.52; 95% CI, 0.34 to 0.79; p=0.002). For nonfatal stroke, the HR was 0.52 (95% CI, 0.33 to 0.80; p=0.003); ischemic stroke HR was 0.49 (95% CI, 0.30 to 0.81; p=0.004). There was no increase in the risk of hemorrhagic stroke (HR 0.67; 95% CI, 0.24 to 1.88; p=0.44). The secondary endpoint, all-cause mortality, decreased 20% with rosuvastatin (HR 0.80; 95% CI, 0.67 to 0.97; p=0.02).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThese results were consistent across all subgroups with patients in high-risk groups (hypertension, smokers, high Framingham risk factors), showing substantial benefits from rosuvastatin treatment. Except for cancer deaths (higher in the placebo group) and the incidence of diabetes (higher in the rosuvastatin group), adverse events were similar between the treatment groups.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003ECompared with previous trials (WOSCOPS and AFCAPS), the JUPITER trial showed significant positive effects on stroke reduction. Dr. Glynn suggested that these benefits may be due to JUPITER\u0027s larger patient population, patient characteristics (more women and lower LDL levels in the JUPITER trial and higher smoking and lipid levels in the WOSCOPS trial), or the treatment (rosuvastatin in JUPITER, pravastatin in WOSCOPS, and lovastatin in AFCAPS).\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2009 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/9\/1\/11.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzml42\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzml42\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}