Document Detail


Full-dose atorvastatin versus conventional medical therapy after non-ST-elevation acute myocardial infarction in patients with advanced non-revascularisable coronary artery disease.
MedLine Citation:
PMID:  20367555     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: This study tested the hypothesis that the addition of full-dose atorvastatin (80 mg/day) to conventional medical treatment could reduce ischaemic recurrences after non-ST-elevation acute myocardial infarction (NSTE-AMI) in patients with severe and diffuse coronary artery disease (CAD) not amenable to any form of mechanical revascularisation. METHODS AND RESULTS: The study was an open-label, randomised, controlled, blinded end-point classification trial, employing the PROBE (Prospective Open Treatment and Blinded End Point Evaluation) design. A total of 290 patients (mean age 74.6 +/- 9.6 years) with NSTE-AMI and angiographic evidence of severe and diffuse CAD, not amenable to revascularisation by either coronary surgery or angioplasty, were randomised to atorvastatin 80 mg/day (n = 144) or conventional medical treatment (n = 146). A primary end point event (combination of cardiovascular death, non-fatal acute myocardial reinfarction and disabling stroke within 12 months of randomisation) occurred in 16.0% of patients treated with atorvastatin 80 mg/day and in 26.7% of patients receiving conventional treatment (HR 0.56; 95% CI 0.33-0.93, p = 0.027). The study was not blinded. Consequently, a bias in the assessment of clinical outcome cannot be completely excluded. CONCLUSIONS: In conclusion, when compared with a conventional treatment strategy, full-dose therapy with atorvastatin 80 mg/day provides greater protection against ischaemic recurrences after NSTE-AMI in patients with severe, diffuse, non-revascularisable CAD.
Authors:
Furio Colivicchi; Marco Tubaro; David Mocini; Alberto Genovesi Ebert; Stefano Strano; Giovanni Melina; Massimo Uguccioni; Massimo Santini
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Current medical research and opinion     Volume:  26     ISSN:  1473-4877     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-09-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  England    
Other Details:
Languages:  eng     Pagination:  1277-84     Citation Subset:  IM    
Affiliation:
Cardiology Division, Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy. f.colivicchi@sanfilipponeri.roma.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anticholesteremic Agents / administration & dosage*,  pharmacology
Coronary Artery Disease / drug therapy*
Dose-Response Relationship, Drug
Female
Heptanoic Acids / administration & dosage*,  pharmacology
Humans
Italy
Male
Myocardial Infarction*
Myocardial Ischemia / prevention & control
Pyrroles / administration & dosage*,  pharmacology
Recurrence
Treatment Outcome
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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