Abstract 3728: Intensive Lipid Lowering with Atorvastatin Provides Early and Sustained Benefit in Patients with Stable Coronary Disease: A Secondary Analysis of the Treating to New Targets (TNT) Study
Background: In TNT, intensive lipid lowering with atorvastatin 80 mg significantly reduced the risk of CV disease compared with atorvastatin 10 mg among patients with stable CHD. This analysis was designed to determine how soon after treatment initiation the additional clinical benefit observed among patients receiving atorvastatin 80 mg was demonstrated.
Methods: 10,001 patients with stable CHD were randomized to double-blind therapy with atorvastatin 10 or 80 mg and followed for 4.9 years. We analyzed the occurrence of the primary end point of major CV events (death from CHD, nonfatal non-procedure-related MI, resuscitated cardiac arrest, or fatal or nonfatal stroke). To augment the number of events and to see if the primary end point results held true we also analyzed any CV event. Cox proportional hazards modeling was carried out, and the hazard ratios (HR) calculated at monthly intervals over the course of the trial.
Results: The reduction in major CV events in the atorvastatin 80 mg group compared with the atorvastatin 10 mg was apparent early and was sustained for the duration of the study (HR <1.0 at Month 1 and thereafter) (Figure⇓). Treatment with atorvastatin 80 mg was also associated with a reduction in any CV event from early after treatment initiation. This effect was again consistent throughout the study (HR 1.0 at Month 1 and thereafter).
Conclusion: The additional clinical benefit observed among stable CHD patients receiving atorvastatin 80 mg in the TNT study was apparent from early after treatment initiation and was maintained long-term.