Intensive statin therapy benefit in stable CHD patients
Patients with stable coronary heart disease benefit more from intensive than standard lipid-lowering therapy, new data suggest.
In the Treating to New Targets (TNT) trial over 10,000 patients with
coronary heart disease and low-density lipoprotein cholesterol levels
of less than 3.4mmol/L were randomly assigned to receive 10mg or 80mg
atorvastatin (Lipitor; Pfizer) per day. At a median follow up of five
years patients on the aggressive statin therapy had a mean LDL cholesterol
level of 2.0mmol/L, compared with 2.6mmol/L on the 10mg dose.
A major cardiovascular event (death from CHD, non-fatal myocardial infarction,
resuscitation after cardiac arrest or stroke) occurred in 434 patients
(8.7 per cent) taking 80mg atorvastatin compared with 548 patients (10.9
per cent) taking 10mg atorvastatin. This equates to a relative reduction
in risk of 22 per cent (hazard ratio 0.78, 95 per cent confidence interval
0.69 to 0.89, P<0.001). No difference in overall mortality was observed
between the two groups and the high-dose group had a greater incidence
of persistent raised liver enzymes.
The researchers say that these new data add to the growing body of evidence
for the clinical benefit of reducing LDL levels to well below currently
recommended levels.
The data were presented at the American College of Cardiology meeting
this week and was published early online in
the New
England Journal of Medicine.
Meanwhile AstraZeneca has issued a statement saying that rosuvastatin
(Crestor) 20mg offers the same cholesterol lowering benefits as atorvastatin,
without the associated side effects. |
The
Pharmaceutical Journal
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