| The Anglo-Scandinavian Cardiac Outcomes Trial: 11-year mortality follow-up of the lipid-lowering arm in the UK. | |
| | |
MedLine Citation:
|
PMID: 21873710 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
AimsThe aim of this study was to determine the outcome benefits in those originally assigned atorvastatin in the Anglo-Scandinavian Cardiac Outcomes Trial-8 years after closure of the lipid-lowering arm (LLA) of the trial (ASCOT-LLA) among the UK population.Methods and resultsASCOT-LLA was a factorially designed double-blind placebo-controlled trial of atorvastatin in 10 305 hypertensive patients enrolled into the ASCOT-Blood Pressure Lowering Arm (BPLA) of the trial and with total cholesterol concentrations, at baseline, of <6.5 mmol/L. ASCOT-LLA was stopped prematurely after a median 3.3-year follow-up because of a 36% relative risk reduction (RRR) in non-fatal myocardial infarction and fatal coronary heart disease (CHD) (the primary outcome) in favour of atorvastatin and a non-significant reduction in CV deaths (16%) and all-cause mortality (13%). After a further 2.2 years at the end of ASCOT-BPLA, despite extensive crossovers from and to statin usage, the RRR in all endpoints remained essentially unchanged. A median 11 years after initial randomization and ∼8 years after closure of LLA, all-cause mortality (n= 520 and 460 in placebo and atorvastatin, respectively) remained significantly lower in those originally assigned atorvastatin (HR 0.86, CI 0.76-0.98, P= 0.02). CV deaths were fewer, but not significant (HR 0.89, CI 0.72-1.11, P= 0.32) and non-CV deaths were significantly lower (HR 0.85, CI 0.73-0.99, P= 0.03) in those formerly assigned atorvastatin attributed to a reduction in deaths due to infection and respiratory illness.ConclusionLegacy effects of those originally assigned atorvastatin may contribute to long-term benefits on all-cause mortality. An explanation for long-term benefits on non-CV deaths has not been established. |
| | |
Authors:
|
Peter S Sever; Choon L Chang; Ajay K Gupta; Andrew Whitehouse; Neil R Poulter; |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-8-28 |
Journal Detail:
|
Title: European heart journal Volume: - ISSN: 1522-9645 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
|
Created Date: 2011-8-29 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Clinical Pharmacology and Therapeutics, Imperial College London, International Centre for Circulatory Health, 59 North Wharf Road, London W2 1PG, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with ...
Next Document: The conservative management of primary pyomyositis abscess in children: case series and review of th...