Atorvastatin at 80 mg/day reduced cerebrovascular events more than atorvastatin at 10 mg/day in stable coronary heart disease

doi:10.1136/ebm.12.2.43

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Evidence-Based Medicine 2007;12:43; doi:10.1136/ebm.12.2.43
Copyright © 2007 by the BMJ Publishing Group Ltd.

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Therapeutics

Atorvastatin at 80 mg/day reduced cerebrovascular events more than atorvastatin at 10 mg/day in stable coronary heart disease

Waters DD, LaRosa JC, Barter P, et al. Effects of high-dose atorvastatin on cerebrovascular events in patients with stable coronary disease in the TNT (Treating to New Targets) study. J Am Coll Cardiol 2006;48:1793–9.[Abstract/Free Full Text]

Q In patients with stable coronary heart disease (CHD), is intensive atorvastatin therapy more effective than moderate atorvastatin therapy for reducing cerebrovascular events?

Clinical impact ratings IM/Ambulatory care $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Cardiology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Neurology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Endocrine $*$ $*$ $*$ $*$ $*$ $*$ ${star}$

Key Words: cerebrovascular disorders • cholesterol (LDL) • coronary disease • drug delivery systems • heptanoic acids • pyrroles

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial.

Allocation: {concealed^*}.

Blinding: blinded (clinicians, patients, and endpoints adjudication committee).^*

Follow up period: median 4.9 years.

Setting: 256 sites in 14 countries across 4 continents.

Patients: 10 001 patients 35–75 years of age (mean age 61 y, 81%men) who had clinically evident CHD (defined as previous myocardialinfarction or coronary revascularisation, or previous or currentangina with objective evidence of CHD), low density lipoproteincholesterol (LDL-C) concentration 130–250mg/dl (3.4–6.5mmol/l), and triglyceride concentration $<=$ 600 mg/dl (6.8 mmol/l).LDL-C concentration was required to be <130 mg/dl (3.4 mmol/l)during an 8 week run in period with atorvastatin, 10 mg/day.

Intervention: atorvastatin, 80 mg/day (n = 4995) or atorvastatin, 10 mg/day(n = 5006), with target mean LDL-C concentrations 75 mg/dl (1.9mmol/l) and 100 mg/dl (2.6 mmol/l), respectively.

Outcomes: cerebrovascular events, including fatal or non-fatal strokeand transient ischaemic attack (TIA) (predefined secondary outcome).

. . . [Full text of this article]

Patrick O’Malley, MD, MPH

Walter Reed Army Medical Center, Washington, DC, USA

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Evid. Based Med. 2007 12: 63-64. (in ) [Extract] [Full Text] [PDF]