CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 1, January/February 2010
64
AFRICA
More than 50% reduction in ischaemic stroke with rosuvastatin in
the JUPITER study
Treatment with rosuvastatin resulted in a
51% reduction in the incidence of ischae-
mic stroke, a component of the primary
endpoint in both men and women in the
JUPITER study.
1
In addition, there was
no difference in the rates of haemorrhagic
stroke between the rosuvastatin-treated
and placebo arms.
This significant reduction in ischaemic
stroke raises the argument for the prevent-
ative role of statins in patients with low
levels of cholesterol, but with elevat-
ed levels of high-sensitivity C-reactive
protein (hsCRP). Patients in this study had
LDL cholesterol levels below 130 mg/dl
and hsCRP
≥
2.0 mg/l.
This benefit of a 48% reduction in the
hazard of fatal and non-fatal stroke was
seen after a median follow up of 1.9 years.
This was consistent across all examined
subgroups (gender, ethnicity, with/with-
out traditional risk factors, older than 70
years). At the time of study termination,
33 strokes had occurred in the rosuvasta-
tin group compared with 64 strokes in the
placebo group.
The incidence rates of stroke were 0.18
and 0.34 per 100 person years of follow
up in the rosuvastatin and placebo groups,
respectively. Most strokes were catego-
rised as ischaemic (0.12 and 0.25 per 100
person years, respectively). The rates of
haemorrhagic stroke were 0.03 and 0.05
per 100 person years in the rosuvastatin
and placebo groups, respectively.
The projected number of patients
needed to treat for five years to prevent
one stroke was 123. It should be noted
that when stroke was excluded from
the primary cardiovascular endpoint of
myocardial infarction, stroke, unstable
angina, revascularisation and cardio-
vascular death, the number needed to
prevent one event was 31 patients at five
years. However, if stroke was included,
the number needed to treat at five years
was 25. The trial investigators ascribe
this benefit to the more potent statin used
and the selection of patients with raised
hsCRP, who have been shown to be at
greater stroke risk.
Everett BM, Glynn RJ, Macfadyen JG,
1.
Ridker PM. Rosuvastatin in the prevention of
stroke among men and women with elevated
levels of C-reactive protein. DOI: 10.1161
Circulation
109.874834.
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The 7th Scientific Congress of the Cameroon Cardiac Society (CCS)
will be held from 17–19 March 2010 in Yaoundé.
The theme is ‘cardiac surgery – congenital heart diseases’, but the diversity of
secondary themes brings together cardiologists, surgeons, paediatricians, internists,
epidemiologists, anaesthesiologists, nurses and paramedical technicians.
Your abstracts, from these areas of medical practice are welcome.
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