Extreme All-Cause Mortality in JUPITER Requires Reexamination of Vital Records

<i>Objective:</i> To compare all-cause mortality in JUPITER with other statin trials at 21 months of follow-up. <i>Background:</i> Outcome advantages including all-cause mortality reduction yielded from the JUPITER trial support aggressive use of rosuvastatin and, perhaps by extension, other statins for primary prevention. Despite enrolling apparently healthy subjects and early trial termination at 21 months of mean follow-up, JUPITER revealed very high all-cause mortality in both the placebo (2.8%) and rosuvastatin (2.2%) arms. <i>Methods:</i> Comparison of all-cause mortality prorated for 21 months in 10 primary prevention studies and 1 acute coronary syndromes statin trial. <i>Findings:</i> The all-cause mortality in JUPITER was more than twice that of the average of primary prevention studies, matching well only with specific trials designed in diabetics (ASPEN or CARDS), early hypertension studies (ALLHAT-LLT) or a trial in patients with acute coronary syndromes (PROVE IT). Since the ‘play of chance’ is unlikely to explain these discrepancies due to excellent baseline match, excess death rates and all-cause mortality rates in bot