tailieunhanh - Intensive Lipid Lowering with Atorvastatin in Patients with Stable Coronary Disease

Previous trials have demonstrated that lowering low-density lipoprotein (LDL) cholesterol levels below currently recommended levels is beneficial in patients with acute coronary syndromes. We prospectively assessed the efficacy and safety of lowering LDL cholesterol levels below 100 mg per deciliter ( mmol per liter) in patients with stable coronary heart disease (CHD). | Intensive Lipid Lowering with Atorvastatin in Patients with Stable Coronary Disease Intensive Lipid Lowering with Atorvastatin in Patients with Stable Coronary Disease John C. LaRosa . Scott M. Grundy . . David D. Waters . Charles Shear . Philip Barter . . Jean-Charles Fruchart . . Antonio M. Gotto . . Heiner Greten . John . Kastelein . James Shepherd . and Nanette K. Wenger . for the Treating to New Targets TNT Investigators abstract background Previous trials have demonstrated that lowering low-density lipoprotein LDL cholesterol levels below currently recommended levels is beneficial in patients with acute coronary syndromes. We prospectively assessed the efficacy and safety of lowering LDL cholesterol levels below 100 mg per deciliter mmol per liter in patients with stable coronary heart disease CHD . methods A total of10 001 patients with clinically evident CHD and LDL cholesterol levels ofless than 130 mg per deciliter mmol per liter were randomly assigned to double-blind therapy and received either 10 mg or 80 mg of atorvastatin per day. Patients were followed for a median of years. The primary end point was the occurrence of a first major cardiovascular event defined as death from CHD nonfatal non-procedure-relat-ed myocardial infarction resuscitation after cardiac arrest or fatal or nonfatal stroke. results The mean LDL cholesterol levels were 77 mg per deciliter mmol per liter during treatment with 80 mg ofatorvastatin and 101 mg per deciliter mmol per liter during treatment with 10 mg ofatorvastatin. The incidence ofpersistent elevations in liver aminotransferase levels was percent in the group given 10 mg of atorvastatin and percent in the group given 80 mg of atorvastatin P . A primary event occurred in 434 patients percent receiving 80 mg of atorvastatin as compared with 548 patients percent receiving 10 mg of atorvastatin representing an absolute .