During a follow-up of up to five years, people taking Crestor had a 54 percent reduction in heart attack and 48 percent decrease in stroke.
In addition, people taking Crestor had a 46 percent reduction in revascularization (surgery to restore an adequate blood supply to part of the body through a blood vessel graft, like a coronary bypass) and a 43 percent decrease in venous thromboembolism (a blood clot in the leg). There was also a 20 percent decrease in total mortality.
However, when the researchers looked at the effect of "good" cholesterol on reducing the risk of heart attack and stroke, they found no significant relationship between levels of good cholesterol and cardiovascular risk among people taking Crestor.
Among people in the trial given a placebo, levels of good cholesterol remained predictive of cardiovascular risk. Among people with the highest levels of HDL cholesterol, the risk of heart attack or stroke was about half that of those with the lowest HDL levels, Ridker's group found.
"One of the implications of this work is to rethink just how important HDL cholesterol remains once we get LDL levels very low with potent statin therapy," Ridker said. "Clinically, these data suggest that once on a high-dose statin, it is unclear if HDL cholesterol remains an important determinant of residual risk."
"These data do not diminish our need to find out once and for all whether potent HDL-raising agents might improve cardiovascular outcomes," Ridker said. The researchers said that further clincial trials were needed to make that determination.
The JUPITER trial was funded by the pharmaceutical giant AstraZeneca, the maker of Crestor.
Dr. Gregg C. Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center at the University of California, Los Angeles, said that "while statin therapy lowers the
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