دورية أكاديمية
Intensive lipid lowering with atorvastatin in patients with coronary heart disease and chronic kidney disease: the TNT (Treating to New Targets) study.
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 |
تدمد: | 1558-3597 |
---|---|
DOI: | 10.1016/j.jacc.2007.11.072 |