List of Authors:
Robert J Glynn and Paul M Ridker on behalf of the JUPITER Trial Study Group
Abstract:
Relationships of cholesterol levels with cardiovascular risk weaken with advancing age, and use of statins for primary prevention in older people remains controversial.
Among the 17802 apparently healthy men and women randomized in the JUPITER trial, 5695 were initially age 70 years or older. The trial was stopped after a median follow-up of 1.9 years (maximum, 5.0) on the basis of convincing evidence of efficacy with respect to the combined primary end point. We present here the observed effects of rosuvastatin in participants age 70 years or older, based on intention-to-treat analyses, for the composite primary end point and the pre-specified secondary end points of total mortality, venous thromboembolism, and incident diabetes.
The 32% of participants in the JUPITER trial who were aged 70 years or older accrued 49% (N=194) of the 393 confirmed primary end points. The rates of the primary end point in this age group were 1.22 and 1.99 per 100 person-years of follow-up in the rosuvastatin and placebo groups, respectively (hazard ratio 0.61; [95% CI, 0.46 to 0.82]; P<0.001). Corresponding rates of secondary end points in this age group were 1.63 and 2.04 for any death (hazard ratio 0.80; [95% CI, 0.62 to 1.04]; P=0.090), 0.24 and 0.41 for venous thromboembolism (hazard ratio 0.58; [95% CI, 0.31 to 1.11] P=0.096), and 1.20 and 0.98 for diabetes (hazard ratio 1.21; [95% CI, 0.86 to 1.71]; P=0.27). Thus, relative effects observed in older participants were quite similar to those reported for the overall trial.
However, because absolute risks were substantially higher in this age group, the estimated number needed to treat (NNT) for 5 years to prevent 1 primary end point was 19, compared with the estimated NNT of 25 for the overall trial.
Report:
Notes to editor
This congress report accompanies a presentation given at the ESC Congress 2009. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.