Akademik Veri Yönetim Sistemi
Türk Kardiyoloji Derneǧi arşivi : Türk Kardiyoloji Derneǧinin yayin organidir, cilt.37 Suppl 4, ss.18-26, 2009 (SCI-Expanded)
Current practice guidelines recommend that, when determining target LDL-cholesterol levels in individuals without cardiovascular disease and diabetes, global risk estimation be made taking into account age, sex, total cholesterol level, HDL-cholesterol level, smoking status, and systolic blood pressure. Based on this assessment, target LDL-cholesterol levels have been set as <100 mg/dL, <130 mg/dL, and <160 mg/dL for high-, intermediate-, and low-risk individuals, respectively. The most important rationale for this approach is to implement a cost-effective treatment strategy, giving special attention to high-risk individuals when allocating available sources. Recent data suggest that increased levels of high sensitive C-reactive protein (hs-CRP) are associated with increased risk for cardiovascular events, independent of other risk parameters. Most recently, the JUPITER trial demonstrated that rosuvastatin 20 mg/day significantly lowered cardiovascular mortality and all-cause mortality in low- or intermediate-risk patients whose LDL-cholesterol levels were <130 mg/dL (median 108 mg/dL) and hs-CRP levels were =/>2 mg/L. As the current guidelines do not recommend statin therapy for this patient group, these results have caused a widespread interest, giving rise to arguments about the effectiveness of primary prevention recommendations of the guidelines. This review aims to discuss the results and implications of the JUPITER trial.