دورية أكاديمية
Intensive lipid-lowering with atorvastatin for secondary prevention in patients after coronary artery bypass surgery.
العنوان: | Intensive lipid-lowering with atorvastatin for secondary prevention in patients after coronary artery bypass surgery. |
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المؤلفون: | Shah SJ; Division of Cardiology, San Francisco General Hospital, University of California, San Francisco, California 94110, USA., Waters DD, Barter P, Kastelein JJ, Shepherd J, Wenger NK, DeMicco DA, Breazna A, LaRosa JC |
المصدر: | Journal of the American College of Cardiology [J Am Coll Cardiol] 2008 May 20; Vol. 51 (20), pp. 1938-43. |
نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
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/*administration & dosage , Coronary Artery Disease/*surgery , Coronary Restenosis/*prevention & control , Graft Occlusion, Vascular/*prevention & control , Heptanoic Acids/*administration & dosage , Pyrroles/*administration & dosage, Adult ; Aged ; Atorvastatin ; Cholesterol, LDL/blood ; Coronary Artery Bypass ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Triglycerides/blood |
مستخلص: | Objectives: The aim of this post hoc analysis from the TNT (Treating to New Targets) trial is to determine whether patients with previous coronary artery bypass grafting (CABG) surgery achieved clinical benefit from intensive low-density lipoprotein (LDL)-cholesterol lowering. Background: The development and progression of atherosclerosis is accelerated in coronary venous bypass grafts. Methods: A total of 10,001 patients with documented coronary disease, including 4,654 with previous CABG, were randomized to atorvastatin 80 or 10 mg/day and were followed for a median of 4.9 years. The primary end point was the occurrence of a first major cardiovascular event (cardiac death, nonfatal myocardial infarction, resuscitated cardiac arrest, or stroke). Results: A first major cardiovascular event occurred in 11.4% of the patients with prior CABG and 8.5% of those without prior CABG (p < 0.001). In CABG patients, mean LDL-cholesterol levels at study end were 79 mg/dl in the 80-mg arm and 101 mg/dl in the 10-mg arm, and the primary event rate was 9.7% in the 80-mg arm and 13.0% in the 10-mg arm (hazard ratio 0.73, 95% confidence interval 0.62 to 0.87, p = 0.0004). Repeat revascularization during follow-up, either CABG or percutaneous coronary intervention, was performed in 11.3% of the CABG patients in the 80-mg arm and 15.9% in the 10-mg arm (hazard ratio 0.70, 95% confidence interval 0.60 to 0.82, p < 0.0001). Conclusions: Intensive LDL-cholesterol lowering to a mean of 79 mg/dl with atorvastatin 80 mg/day in patients with previous CABG reduces major cardiovascular events by 27% and the need for repeat coronary revascularization by 30%, compared with less intensive cholesterol-lowering to a mean of 101 mg/dl with atorvastatin 10 mg/day. (A Study to Determine the Degree of Additional Reduction in CV Risk in Lowering LDL Below Minimum Target Levels [TNT]; NCT00327691). |
سلسلة جزيئية: | ClinicalTrials.gov NCT00327691 |
المشرفين على المادة: | 0 (Anticholesteremic Agents) 0 (Cholesterol, LDL) 0 (Heptanoic Acids) 0 (Pyrroles) 0 (Triglycerides) A0JWA85V8F (Atorvastatin) |
تواريخ الأحداث: | Date Created: 20080517 Date Completed: 20080612 Latest Revision: 20181201 |
رمز التحديث: | 20221213 |
DOI: | 10.1016/j.jacc.2007.12.054 |
PMID: | 18482661 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1558-3597 |
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DOI: | 10.1016/j.jacc.2007.12.054 |