For older patients without hyperlipidemia, but with heightened high-sensitivity C-reactive protein levels, rosuvastatin (Crestor; AstraZeneca) can decrease incidence rates of major cardiovascular events (MACE), according to a substudy of the JUPITER trial published April 20 in the Annals of Internal Medicine.
“Randomized data on statins for primary prevention in older persons are limited, and the relative hazard of cardiovascular disease associated with an elevated cholesterol level weakens with advancing age,” the authors wrote.
To alleviate the scarce data, Robert J. Glynn, PhD, ScD, of the Brigham and Women’s Hospital and Harvard Medical School in Boston, and colleagues evaluated the safety and efficacy of rosuvastatin in patients 70 years or older at 1,315 sites throughout 26 countries.
Of the 17,802 patient cohort in the JUPITER trial, the researchers identified 5,695 patients who were over 70, had no signs of cardiovascular disease (CVD) and who exhibited low-density lipoprotein (LDL) cholesterol levels that were less than 3.37 mmol/L and D-reactive protein levels of 2 mg/L or greater.
During the study, the researchers randomly assigned patients to receive a 20 mg dose of rosuvastatin or placebo at a 1:1 ratio. The primary endpoint measured CVD events including MI, stroke, arterial revascularization, hospitalization for angina or mortality.
The results showed that 32 percent of the patients 70 years or older had incident rates of 49 percent of the 393 primary endpoints.
According to the authors, the incident rates of primary endpoints for those 70 years or older were 1.22 and 1.99 for 100 person-years of follow-up in the rosuvastatin and placebo groups, respectively.
The rates of mortality for both of the aforementioned groups were 1.63 and 2.04, respectively.
While differences in mortality rates were not significant, older patients who took rosuvastatin had fewer heart problems and strokes compared to the placebo group.
“Although no significant heterogeneity was found in treatment effects by age,” the authors wrote, “absolute reductions in event rates associated with rosuvastatin were greater in older persons.”
The study was funded by AstraZeneca.