دورية أكاديمية
أعرض في EDS

Intensive lipid lowering with atorvastatin in patients with coronary heart disease and chronic kidney disease: the TNT (Treating to New Targets) study.

التفاصيل البيبلوغرافية
العنوان: Intensive lipid lowering with atorvastatin in patients with coronary heart disease and chronic kidney disease: the TNT (Treating to New Targets) study.
المؤلفون: Shepherd J; University of Glasgow, Glasgow, United Kingdom. jshepherd@gri-biochem.org.uk, Kastelein JJ, Bittner V, Deedwania P, Breazna A, Dobson S, Wilson DJ, Zuckerman A, Wenger NK
مؤلفون مشاركون: TNT (Treating to New Targets) Investigators
المصدر: Journal of the American College of Cardiology [J Am Coll Cardiol] 2008 Apr 15; Vol. 51 (15), pp. 1448-54.
نوع المنشور: Journal Article; Randomized Controlled Trial
اللغة: English
بيانات الدورية: Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print Cited Medium: Internet ISSN: 1558-3597 (Electronic) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983-
مواضيع طبية MeSH: Anticholesteremic Agents/*therapeutic use , Coronary Artery Disease/*drug therapy , Heptanoic Acids/*therapeutic use , Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use , Kidney Failure, Chronic/*complications , Lipids/*blood , Pyrroles/*therapeutic use, Adult ; Aged ; Atorvastatin ; Cholesterol, LDL/blood ; Cholesterol, LDL/drug effects ; Coronary Artery Disease/physiopathology ; Double-Blind Method ; Female ; Glomerular Filtration Rate/drug effects ; Humans ; Kidney Failure, Chronic/physiopathology ; Male ; Middle Aged ; Risk ; Triglycerides/blood
مستخلص: Objectives: This subanalysis of the TNT (Treating to New Targets) study investigates the effects of intensive lipid lowering with atorvastatin in patients with coronary heart disease (CHD) with and without pre-existing chronic kidney disease (CKD).
Background: Cardiovascular disease is a major cause of morbidity and mortality in patients with CKD.
Methods: A total of 10,001 patients with CHD were randomized to double-blind therapy with atorvastatin 80 mg/day or 10 mg/day. Patients with CKD were identified at baseline on the basis of an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) using the Modification of Diet in Renal Disease equation. The primary efficacy outcome was time to first major cardiovascular event.
Results: Of 9,656 patients with complete renal data, 3,107 had CKD at baseline and demonstrated greater cardiovascular comorbidity than those with normal eGFR (n = 6,549). After a median follow-up of 5.0 years, 351 patients with CKD (11.3%) experienced a major cardiovascular event, compared with 561 patients with normal eGFR (8.6%) (hazard ratio [HR] = 1.35; 95% confidence interval [CI] 1.18 to 1.54; p < 0.0001). Compared with atorvastatin 10 mg, atorvastatin 80 mg reduced the relative risk of major cardiovascular events by 32% in patients with CKD (HR = 0.68; 95% CI 0.55 to 0.84; p = 0.0003) and 15% in patients with normal eGFR (HR = 0.85; 95% CI 0.72 to 1.00; p = 0.049). Both doses of atorvastatin were well tolerated in patients with CKD.
Conclusions: Aggressive lipid lowering with atorvastatin 80 mg was both safe and effective in reducing the excess of cardiovascular events in a high-risk population with CKD and CHD.
سلسلة جزيئية: ClinicalTrials.gov NCT00327691
المشرفين على المادة: 0 (Anticholesteremic Agents)
0 (Cholesterol, LDL)
0 (Heptanoic Acids)
0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
0 (Lipids)
0 (Pyrroles)
0 (Triglycerides)
A0JWA85V8F (Atorvastatin)
تواريخ الأحداث: Date Created: 20080412 Date Completed: 20080505 Latest Revision: 20220317
رمز التحديث: 20221213
DOI: 10.1016/j.jacc.2007.11.072
PMID: 18402899
قاعدة البيانات: MEDLINE
الوصف
تدمد:1558-3597
DOI:10.1016/j.jacc.2007.11.072