Statin Therapy for Low-LDL, High-hsCRP Patients: From JUPITER to CORONA
Bibliographic record
Abstract
In the recently completed Justification for Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER)1 trial, which was conducted with 17 802 primary-prevention patients with LDL cholesterol concentrations <3.37 mmol/L (<130 mg/dL) and high-sensitivity C-reactive protein (hsCRP) concentrations ≥2 mg/L, random allocation to treatment with 20 mg rosuvastatin was associated with a 54% reduction in the incidence of myocardial infarction, a 48% reduction in stroke, a 47% reduction in the need for angioplasty or bypass surgery, a 43% reduction in venous thrombosis, and a 20% reduction in all-cause mortality (1). These effects were consistent in all of the evaluated subgroups, including among women as well as men, among minority populations, at all levels of Framingham risk, and among those with and without metabolic syndrome. Within the JUPITER trial, as had previously been shown in high-risk patients with acute coronary ischemia and among those with stable coronary disease, the clinical benefits of statin therapy compared with placebo were greatest among patients who reduced not only their LDL cholesterol concentration but also their hsCRP value (2). On the basis of these data, an advisory panel to the US Food and Drug Administration recently voted in favor of expanding the labeling for statin therapy to include those with low LDL cholesterol and increased hsCRP. Furthermore, 2009 guidelines from the Canadian Cardiovascular Society—the first national guidelines to appear since publication of the JUPITER trial data—now explicitly endorse hsCRP screening among “intermediate risk” patients, including those with low LDL cholesterol concentrations (3). The concept that low-LDL, high-hsCRP patients are at a higher than anticipated vascular risk and thus good candidates for statin therapy has also recently been confirmed in the multiethnic Atherosclerosis Risk in Communities (ARIC) study, in which patients with low LDL cholesterol values but high hsCRP concentrations had a substantially …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".