Efficacy of Rosuvastatin Among Men and Women With Moderate Chronic Kidney Disease and Elevated High-Sensitivity C-Reactive Protein A Secondary Analysis From the JUPITER (Justification for the Use of Statins in Prevention-an Intervention Trial Evaluating Rosuvastatin) Trial
Efficacy of Rosuvastatin Among Men and Women With Moderate Chronic Kidney Disease and Elevated High-Sensitivity C-Reactive Protein A Secondary Analysis From the JUPITER (Justification for the Use of Statins in Prevention-an Intervention Trial Evaluating Rosuvastatin) Trial
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DOI：
10.1016/j.jacc.2010.01.020
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发表时间：
2010-03-23
影响因子：
24
通讯作者：
Glynn, Robert J.
中科院分区：
文献类型：
--
作者：
Ridker, Paul M.;MacFadyen, Jean;Glynn, Robert J.
目的我们评估他汀类药物治疗在中度慢性肾脏病（CKD）患者一级预防中的有效性。背景无论是中度CKD患者（估计肾小球滤过率[eGFR] = 60 ml/min/1.73 m2）（n = 14，528）。结果与eGFR >= 60 ml/min/1.73 m2的患者相比，中度CKD患者的血管事件发生率更高（风险比[HR]：1.54，95%可信区间[CI]：1.23 - 1.92，p = 0.0002）。在中度CKD患者中，瑞舒伐他汀可使心肌梗死、卒中、不稳定型心绞痛住院时间、动脉血运重建或经证实的心血管死亡风险降低45（HR：0.55，95% CI：0.38至0.82，p = 0.002）和全因死亡率降低44%（HR：0.56，95% CI：0.37至0.85，p = 0.005）。在伴和不伴CKD的患者中，与瑞舒伐他汀相关的中位LDL-C和hsCRP降低以及副作用特征相似。与安慰剂组相比，瑞舒伐他汀组12个月时的中位eGFR略有改善。结论瑞舒伐他汀可降低LDL-C男性和女性的首次心血管事件和全因死亡率
Objectives We evaluated the efficacy of statin therapy in primary prevention among individuals with moderate chronic kidney disease (CKD).Background Whether patents with moderate CKD (estimated glomerular filtration rate [eGFR] = 60 ml/min/1.73 m(2) (n = 14,528). Median follow-up was 1.9 years (maximum 5 years).Results Compared with those with eGFR >= 60 ml/min/1.73 m(2), JUPITER participants with moderate CKD had higher vascular event rates (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.23 to 1.92, p = 0.0002). Among those with moderate CKD, rosuvastatin was associated with a 45% reduction in risk of myocardial infarction, stroke, hospital stay for unstable angina, arterial revascularization, or confirmed cardiovascular death (HR: 0.55, 95% CI: 0.38 to 0.82, p = 0.002) and a 44% reduction in all-cause mortality (HR: 0.56, 95% CI: 0.37 to 0.85, p = 0.005). Median LDL-C and hsCRP reductions as well as side effect profiles associated with rosuvastatin were similar among those with and without CKD. Median eGFR at 12 months was marginally improved among those allocated to rosuvastatin as compared with placebo.Conclusions Rosuvastatin reduces first cardiovascular events and all-cause mortality among men and women with LDL-C