Abstract 1425: Prevention of Major Cardiovascular Events With Rosuvastatin Among Patients With Impaired Fasting Glucose: The JUPITER Trial
Few randomized data are available regarding primary prevention of cardiovascular disease (CVD) among patients with impaired fasting glucose (IFG), an important clinical issue as several major trials suggest a slight increased risk of diabetes when such patients are treated with statin therapy. The Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial demonstrated that cholesterol lowering therapy with rosuvastatin reduced the primary composite endpoint of coronary heart disease, stroke, arterial revascularization, hospitalization for unstable angina and death from cardiovascular causes in 17,802 apparently healthy men and women without prior CVD or clinical diabetes and with LDL-C levels <130 mg/dl and high-sensitivity C-reactive protein (hsCRP) levels ≥2.0 mg/L (HR 0.56, p<0.00001). We compared the effect of rosuvastatin (20 mg/d) over a median follow-up of 1.9 years (maximum 5 years) on incident cardiovascular events among JUPITER subjects with IFG (n=5504) and normal fasting glucose (NFG;n=12170) at baseline. As shown in the Figure⇓, rosuvastatin significantly reduced the risk of major CVD events in both groups; the HR for rosuvastatin was 0.69 (95% CI 0.49 – 0.98;p=0.037) among subjects with IFG and 0.51 (0.40 – 0.67;p<0.001) in subjects with NFG. No evidence of heterogeneity was observed between groups. Thus, as previously demonstrated in the JUPITER trial for those with and without metabolic syndrome and for those with and without obesity, these data confirm the large cardiovascular benefits of rosuvastatin when given to individuals with and without IFG, at least if LDL-C is <130 mg/dL and hsCRP is ≥2 mg/L.