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  • Atorvastatin was at least as effective as PTCA for reducing ischaemic events in patients with stable coronary artery disease

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Therapeutics
Atorvastatin was at least as effective as PTCA for reducing ischaemic events in patients with stable coronary artery disease

https://doi.org/10.1136/ebm.5.1.14

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    (1999) N Engl J Med 341, 70. Pitt B, Waters D, Brown WV, et al. for the Atorvastatin versus Revascularization Treatment Investigators.. Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease.. Jul 8;. :. –6.
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 QUESTION: In patients with stable coronary artery disease (CAD), is atorvastatin as effective as percutaneous transluminal coronary angioplasty (PTCA) plus usual care for reducing ischaemic events?

    Design

    Randomised, blinded (outcome assessors),* controlled trial with 18 months follow-up.

    Setting

    37 clinical centres in North America and Europe.

    Patients

    341 patients (mean age 59 y, 85% men, 95% white) recommended for PTCA who had stable CAD and asymptomatic or Canadian Cardiovascular Society class I or II angina, low-density lipoprotein (LDL) cholesterol level ≥3.0 mmol/l (115 mg/dl), triglyceride level ≤5.6 mmol/l (500 mg/dl), and stenosis ≥50% in ≥1 coronary artery. Exclusion criteria were left main CAD, triple-vessel disease, ejection fraction <40%, or recent unstable angina or myocardial infarction (MI). Follow-up was 100%.

    Intervention

    164 patients were allocated to atorvastatin, 80 mg/day, and were required to stop other lipid-lowering treatments. 177 patients were allocated to PTCA and usual …

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    Footnotes

    • Source of funding: Parke-Davis Pharmaceutical Research.

    • For correspondence: Dr B Pitt, Division of Cardiology, University of Michigan Medical Center, 3910 Taubman, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0366, USA. FAX 734-936-5256.

    • ↵* See glossary.