Abstract 12482: Differing Predictive Value of LDL Cholesterol and Systolic Blood Pressure on Components of CV Events in 21,727 High-Risk Patients With CHD and/or Diabetes: Pooled Analyses of TNT, IDEAL, and CARDS Trials
Background: We investigated the effect of baseline systolic blood pressure (SBP) and baseline LDL-C on the risk of various vascular outcomes in a large population of patients at high-risk of future cardiovascular (CV) events.
Methods: Data were pooled from the TNT (atorvastatin [ATV] 10 mg vs 80 mg in stable CHD patients), IDEAL (ATV 80 mg vs simvastatin 20-40 mg in post-MI patients) and CARDS (ATV 10 mg vs placebo in patients with type 2 diabetes and without established CHD) trials. A total of 21,727 patients (10,001 from TNT; 8888 from IDEAL; 2838 from CARDS) were included in this analysis. The effect of baseline SBP and baseline LDL-C on CV events, coronary events and stroke was evaluated. The pooled analysis was based on a bivariate Cox model, including baseline SBP and baseline LDL-C as the two predictor variables and stratifying by study.
Results: In the pooled dataset, risk of CV events was significantly higher for patients with higher baseline SBP or LDL-C (Table). Higher baseline SBP was a significant risk factor for stroke, but not for coronary events. Higher baseline LDL-C levels were significantly predictive of coronary events but not stroke. Results for a subgroup of individuals with type 2 diabetes (5408 patients; 1501 from TNT, 1069 from IDEAL, and 2838 from CARDS) were consistent with those of the overall cohort; baseline SBP and LDL-C were again significantly predictive for the risk of CV events, with the association to SBP predominantly related to effect on stroke and that of LDL-C to effect on coronary events.
Conclusions: In this cohort of high-risk patients, baseline SBP and LDL-C were significantly predictive of CV outcomes, but the effect of the studied factors appears to be different on the cerebrovascular and coronary systems. Understanding the effect of such traditional risk factors, should contribute to the planning of both clinical research and clinical care for patients at high-risk of CV disease.
- © 2011 by American Heart Association, Inc.