Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein
Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein
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DOI：
10.1056/nejmoa0807646
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发表时间：
2008-11-20
影响因子：
158.5
通讯作者：
Glynn, Robert J.
中科院分区：
文献类型：
--
作者：
Ridker, Paul M.;Danielson, Eleanor;Glynn, Robert J.
背景：炎症生物标志物高敏C反应蛋白水平升高可预测心血管事件。由于他汀类药物降低了高敏C反应蛋白水平和胆固醇水平，我们假设高敏C反应蛋白水平升高但没有高脂血症的人可能从他汀类药物治疗中受益。方法：我们随机将17,802名低密度脂蛋白(LDL)胆固醇水平低于每升130毫克(每升3.4 mmol)且高敏C反应蛋白水平每升2.0毫克或更高的男性和女性服用罗伐他汀、每天20毫克或安慰剂，并对他们进行跟踪观察，观察合并主要终点心肌梗死、中风、动脉血运重建、因不稳定型心绞痛住院的情况。结果：中位随访时间为1.9年(最长为5.0年)，试验终止。瑞舒伐他汀降低了50%的低密度脂蛋白胆固醇水平和37%的超敏C反应蛋白水平。瑞舒伐他汀组和安慰剂组每100人年的主要终点发生率分别为0.77和1.36(瑞舒伐他汀组的风险比为0.56；95%可信区间[CI]为0.46至0.69；P
Background: Increased levels of the inflammatory biomarker high-sensitivity C-reactive protein predict cardiovascular events. Since statins lower levels of high-sensitivity C-reactive protein as well as cholesterol, we hypothesized that people with elevated high-sensitivity C-reactive protein levels but without hyperlipidemia might benefit from statin treatment.Methods: We randomly assigned 17,802 apparently healthy men and women with low-density lipoprotein (LDL) cholesterol levels of less than 130 mg per deciliter (3.4 mmol per liter) and high-sensitivity C-reactive protein levels of 2.0 mg per liter or higher to rosuvastatin, 20 mg daily, or placebo and followed them for the occurrence of the combined primary end point of myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or death from cardiovascular causes.Results: The trial was stopped after a median follow-up of 1.9 years (maximum, 5.0). Rosuvastatin reduced LDL cholesterol levels by 50% and high-sensitivity C-reactive protein levels by 37%. The rates of the primary end point were 0.77 and 1.36 per 100 person-years of follow-up in the rosuvastatin and placebo groups, respectively (hazard ratio for rosuvastatin, 0.56; 95% confidence interval [CI], 0.46 to 0.69; P