Abstract 10651: Intensive Lipid Lowering with Atorvastatin is Effective in Significantly Reducing Coronary Risk in Both Obese and Morbidly Obese Patients
Background: Evidence suggests that obesity, and its metabolic consequences including dyslipidemia, is directly related to increased risk for premature coronary heart disease (CHD) morbidity and mortality. The current sub-analysis of the TNT study investigates the effect of intensive lipid lowering with atorvastatin (ATV) 80 mg on the incidence of coronary events (CHD death, nonfatal MI, resuscitated cardiac arrest, revascularization, documented angina) compared with ATV 10 mg in stable CHD patients with obesity or morbid obesity.
Methods and Results: A total of 10,001 patients with coronary disease and LDL-C levels of <130 mg/dL were randomized to double-blind therapy with either ATV 10 mg or 80 mg following 8 weeks' open-label therapy with ATV 10 mg. Obesity was defined as BMI ≥28 kg/m2 (3166 patients) and morbid obesity was defined as BMI ≥35 kg/m2 (347 patients). All analyses were based on both univariate and multivariate Cox proportional hazard models. Compared with ATV 10 mg, treatment with ATV 80 mg significantly reduced the risk of any coronary event in both obese (p=0.01) and morbidly obese patients (p=0.02) (Table). These findings held true in multivariate analyses that adjusted for a number of confounding factors.
Conclusions: Among obese and morbidly obese stable CHD patients, treatment with ATV 80 mg significantly reduced the relative risk of coronary events by 22% and 48%, respectively, compared with a more moderate regimen of ATV 10 mg. Overall, our findings support the use of intensive statin therapy to optimally reduce the risk of subsequent CV events in obese patients with stable CHD.
- © 2011 by American Heart Association, Inc.