Thursday, April 02, 2009

FROM ACC 2009 : JUPITER PLUS DVT

Well, the ACC 2009 at Orlando has ended. We have all learn the lessons that we had learn. I wanted earlier to write something about the Jupiter trial, and forgot. I thought that there were more interesting things to comment on, and so left this one and forgot about it.
Anyway, I wanted to write that the Jupiter trial had a secondary end-point of incidence of Deep Vein thrombosis. The investigators wanted to find out, since this was a large population under study, about 18,000 in all, whether taking Rosuvastatin reduces the incidence of DVT. And the answer is yes, taking rosuvastatin, does reduce DVT, but not acute pulmonary embolism. Looking through the figures, I did not see the breakdown of the numbers that correlated DVT and hs-CRP? I wonder whether the investigators looked into that.
These results made me think. Why did rosuvastatin reduce DVT. The deep veins are venous structures, subjected to low pressure systems, and LDL-cholesterol hardly play a role here. If you then minus hypertension and dyslipidemia from the equation, and still have less thrombosis, then we must come to a conclusion ( mechanistic wise ) that it rosuvastatin plays a role in vasculopathy or vessel wall reaction to trauma or inflammation. Interesting, that must also mean that people who travel frequently in airplanes, maybe those in " coach class " should take rosuvastatin before they fly.
Of course, the other question that will come to mind is whether this benefit is confined to rosuvastatin, or is it a statin class effect? That is left to be determined.
Well, ACC 2009 is over. We have all learned alot. Nothing revolutionary, but plenty of clinical material to help our patients.

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