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  • High dose atorvastatin was superior to standard dose pravastatin in reducing death or major CV events in acute coronary syndrome

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Therapeutics
High dose atorvastatin was superior to standard dose pravastatin in reducing death or major CV events in acute coronary syndrome

https://doi.org/10.1136/ebm.9.5.144

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    Cannon CP, Braunwald E, McCabe CH, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 2004;350:1495–504.
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 Q In patients with an acute coronary syndrome (ACS), is standard dose pravastatin non-inferior to high dose atorvastatin for reducing death or major cardiovascular (CV) events?

    Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★★★☆

    METHODS

    Embedded ImageDesign:

    randomised, placebo controlled trial (Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 [PROVE IT-TIMI 22] trial).

    Embedded ImageAllocation:

    concealed.*

    Embedded ImageBlinding:

    blinded (clinicians and patients).*

    Embedded ImageFollow up period:

    mean 24 months.

    Embedded ImageSetting:

    349 sites in 8 countries.

    Embedded ImagePatients:

    4162 stable patients (mean age 58 y, 78% men) who were hospitalised for an ACS in the previous 10 days, were enrolled after a percutaneous revascularisation procedure (if planned), and had a total cholesterol concentration ⩽240 mg/dl (6.21 mmol/l) taken within the first 24 hours, or <6 months …

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    Footnotes

    • ↵* See glossary.

    • For correspondence: Dr C P Cannon, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA. cpcannonpartners.org

    • Sources of funding: Bristol-Myers Squibb and Sankyo.