Document Detail


Comparison of effectiveness of atorvastatin 10 mg versus 80 mg in reducing major cardiovascular events and repeat revascularization in patients with previous percutaneous coronary intervention (post hoc analysis of the Treating to New Targets [TNT] Study).
MedLine Citation:
PMID:  18993147     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Treating to New Targets (TNT) study demonstrated that intensive atorvastatin therapy to achieve low-density lipoprotein cholesterol concentrations well below recommended target levels provides an incremental clinical benefit in patients with stable coronary artery disease. This post hoc analysis of the TNT study was conducted to investigate whether this benefit extends to patients with previous percutaneous coronary intervention (PCI). A total of 10,001 patients with clinically evident coronary artery disease, including 5,407 patients with previous PCI, were randomized to atorvastatin 10 or 80 mg/day and followed for a median of 4.9 years. The primary end point was the occurrence of a first major cardiovascular event. Revascularization, a component of a secondary end point, was also examined. In patients with previous PCI, mean low-density lipoprotein cholesterol levels at study end were 79.5 mg/dl in the 80-mg arm and 100.8 mg/dl in the 10-mg arm. First major cardiovascular events occurred in 230 patients (8.6%) receiving high-dose atorvastatin and 289 patients (10.6%) receiving low-dose atorvastatin (hazard ratio 0.79, 95% confidence interval 0.67 to 0.94, p = 0.008). Repeat revascularization during follow-up (PCI or coronary artery bypass grafting) was performed in 466 patients (17.3%) in the 80-mg arm and 624 patients (22.9%) in the 10-mg arm (hazard ratio 0.73, 95% confidence interval 0.65 to 0.82, p <0.0001). In conclusion, intensive lipid lowering to a mean low-density lipoprotein cholesterol level of 79.5 mg/dl (2.1 mmol/L) with atorvastatin 80 mg/day in patients with previous PCI reduces major cardiovascular events by 21% and repeat revascularizations by 27% compared with a less intensive lipid-lowering regimen.
Authors:
Colleen Johnson; David D Waters; David A DeMicco; Andrei Breazna; Vera Bittner; Heiner Greten; Scott M Grundy; John C LaRosa
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-09-05
Journal Detail:
Title:  The American journal of cardiology     Volume:  102     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-10     Completed Date:  2008-12-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1312-7     Citation Subset:  AIM; IM    
Affiliation:
University of California San Francisco, San Francisco, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Anticholesteremic Agents / administration & dosage*
Cardiovascular Diseases / etiology,  prevention & control*
Coronary Artery Disease / complications,  therapy*
Female
Follow-Up Studies
Heptanoic Acids / administration & dosage*
Humans
Male
Middle Aged
Pyrroles / administration & dosage*
Reoperation
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Heptanoic Acids; 0/Pyrroles; 110862-48-1/atorvastatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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