Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects .
There was no evidence of any serious harm caused by statin prescription .
Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life .
Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event .
AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins
BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy .
Statins are the first-choice agents .
Previous review s of the effects of statins have highlighted their benefits in people with CVD .
The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required .
OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .
Rosuvastatin for primary prevention in patients with European systematic coronary risk evaluation risk ≥5% or Framingham risk >20%: post hoc analyses of the JUPITER trial requested by European health authorities
Aims On the basis of the JUPITER trial , European health authorities recently approved the use of rosuvastatin to reduce first major cardiovascular events among ‘ high ' global risk primary prevention patients defined either by Framingham risk score > 20 % or European systematic coronary risk evaluation ( SCORE ) ≥5 % . However , as these are post hoc analyses , data describing these subgroups have not previously been available to the clinical community . Methods and results We r and omized 17 802 apparently healthy men aged ≥50 and women ≥60 with low-density lipoprotein cholesterol ( LDL-C ) < 3.4 mmol/L , who were at an increased vascular risk due to elevated levels of C-reactive protein measured with a high-sensitivity ( hs ) assay to rosuvastatin 20 mg daily or placebo . Patients with high global cardiovascular risk at baseline were identified by 10-year Framingham risk score > 20 % or SCORE risk ≥5 % . During 1.8-year median follow-up ( maximum 5 years ) of patients with Framingham risk > 20 % , the rate of myocardial infa rct ion/stroke/cardiovascular death was 9.4 and 18.2 per 1000 person-years in rosuvastatin and placebo-allocated patients , respectively [ hazard ratio ( HR ) : 0.50 , 95 % confidence interval ( CI ) : 0.27–0.93 , P = 0.028 ] . Among patients with SCORE risk ≥5 % , the corresponding rates were 6.9 and 12.0 using a model extrapolating risk for age ≥65 years ( HR : 0.57 , 95 % CI : 0.43–0.78 , P = 0.0003 ) and rates were 5.9 and 12.7 when risk for age was capped at 65 years ( HR : 0.47 , 95 % CI : 0.32–0.68 , P < 0.0001 ) . Conclusion In primary prevention patients with elevated hs C-reactive protein who have high global cardiovascular risk ( 10-year Framingham risk score > 20 % or SCORE risk ≥5 % ) , but LDL-C levels not requiring pharmacologic treatment , rosuvastatin 20 mg significantly reduced major cardiovascular events . Clinical Trial.gov Identifier :
Total cholesterol and LDL cholesterol were reduced in all trials but there was evidence of heterogeneity of effects .
There was no evidence of any serious harm caused by statin prescription .
Evidence available to date showed that primary prevention with statins is likely to be cost-effective and may improve patient quality of life .
Recent findings from the Cholesterol Treatment Trialists study using individual patient data meta- analysis indicate that these benefits are similar in people at lower ( < 1 % per year ) risk of a major cardiovascular event .
AUTHORS ' CONCLUSIONS Reductions in all-cause mortality , major vascular events and revascularisations were found with no excess of adverse events among people without evidence of CVD treated with statins
BACKGROUND Reducing high blood cholesterol , a risk factor for cardiovascular disease ( CVD ) events in people with and without a past history of CVD is an important goal of pharmacotherapy .
Statins are the first-choice agents .
Previous review s of the effects of statins have highlighted their benefits in people with CVD .
The case for primary prevention was uncertain when the last version of this review was published ( 2011 ) and in light of new data an up date of this review is required .
OBJECTIVES To assess the effects , both harms and benefits , of statins in people with no history of CVD .