Cardiovascular Risk: What Good Is Identifying the Lowest of the Low?

Coronary artery calcium may be better than hsCRP for stratifying cardiac risk, but the benefits of using either marker to guide statin treatment in low-risk patients remain unproven.

In the placebo-controlled JUPITER trial, rosuvastatin significantly lowered the incidence of cardiovascular events in healthy men (aged ≥50) and women (aged ≥60) with normal LDL levels (<130 mg/dL) and elevated high-sensitivity C-reactive protein (hsCRP) levels (≥2 mg/L; JW Cardiol Nov 10 2008). To evaluate whether “JUPITER-eligible” patients could be further risk-stratified to avoid potentially unnecessary treatment, investigators analyzed data from >2000 participants in the MESA study who underwent computed tomography for baseline coronary artery calcium (CAC) scores.

A total of 950 MESA participants met JUPITER-eligibility criteria. During a median follow-up of 5.8 years, the 25% of patients with baseline CAC scores >100 accounted for nea…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

Cardiovascular Risk: What Good Is Identifying the Lowest of the Low?

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Reviewing Author