Statin dramatically cuts risk of heart attack and stroke in people with normal cholesterol

A large study of people with normal cholesterol levels has found that the statin drug rosuvastatin can dramatically reduce their risk of heart attack and stroke.

Paul Ridker and colleagues studied 17,802 seemingly healthy men and women with normal LDL-cholesterol levels, but high levels of the inflammatory marker high-sensitivity C-reactive protein. Participants were randomly assigned to treatment with rosuvastatin (20 mg/day) or placebo.

After an average follow-up of 1.9 years, results showed that treatment with rosuvastatin reduced LDL-cholesterol levels by 50% and high-sensitivity C-reactive protein levels by 37%. Furthermore, in comparison to those given the placebo, treatment with rosuvastatin reduced the overall risk of heart attack, stroke, hospital admission for chest pain, or death from cardiovascular disease by 44% and the risk of all-cause mortality by 21%.

"These results definitely surpassed our predictions," said Dr. Jacques Genest, of the Research Institute of the McGill University Health Center in a news release. "We had to stop the study before its scheduled completion, as the benefit of the treatment for the selected patients was so great that we needed to present our findings to the medical community as soon as possible."

The researchers concluded: “In this randomized trial of apparently healthy men and women with elevated levels of high-sensitivity C-reactive protein, rosuvastatin significantly reduced the incidence of major cardiovascular events, despite the fact that nearly all study participants had lipid levels at baseline that were well below the threshold for treatment according to current prevention guidelines. Rosuvastatin also significantly reduced the incidence of death from any cause. The trial also showed robust reductions in cardiovascular events with statin therapy in women and black and Hispanic populations for which data on primary prevention are limited.”

Ridker PM, Danielson E, Fonseca FAH, et al. Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein. NEJM 2008; (10.1056/NEJMoa0807646).

News release: Researchers discover new risk factor for cardiovascular disease, and a way to control it. McGill University Health Centre. November 9th 2008.