OBJECTIVE: To investigate the effects of atorvastatin on long-term prognosis in diabetic patients with high plasma levels of non-high-density lipoprotein cholesterol (non-HDL-C) after percutaneous coronary intervention (PCI). METHODS: A total of 648 diabetic patients with high plasma levels of non-HDL-C who had undergone successful PCI were randomly assigned to therapy group (n=327, atorvastatin, 20 mg/day) or control group (n=321, without any lipid-modifying therapy). Study end points included all-cause death, fatal or nonfatal myocardial infarction (MI), and revascularization. RESULTS: The median follow-up was 21+/-2.9 months. Rates of MI (6.4% versus 12.3%, P=0.013), revascularization (19.2% versus 26.6%, P=0.029) and composite end points (26.9% versus 41.5%, P<0.001) were significantly lower in the atorvastatin group compared with those of the control group, although mortality rate (5.1% versus 7.9%, P=0.196) was not. Patients treated with atorvastatin had significantly improved adjusted event-free survival rate than controls (hazard ratio 0.52, 95% CI 0.30 to 0.91, P=0.022). CONCLUSION:Diabetic patients with high plasma levels of non-HDL-C should receive long-term lipid-modifying drugs after PCI to reduce MI and revascularization rates.
RCT Entities:
OBJECTIVE: To investigate the effects of atorvastatin on long-term prognosis in diabeticpatients with high plasma levels of non-high-density lipoprotein cholesterol (non-HDL-C) after percutaneous coronary intervention (PCI). METHODS: A total of 648 diabeticpatients with high plasma levels of non-HDL-C who had undergone successful PCI were randomly assigned to therapy group (n=327, atorvastatin, 20 mg/day) or control group (n=321, without any lipid-modifying therapy). Study end points included all-cause death, fatal or nonfatal myocardial infarction (MI), and revascularization. RESULTS: The median follow-up was 21+/-2.9 months. Rates of MI (6.4% versus 12.3%, P=0.013), revascularization (19.2% versus 26.6%, P=0.029) and composite end points (26.9% versus 41.5%, P<0.001) were significantly lower in the atorvastatin group compared with those of the control group, although mortality rate (5.1% versus 7.9%, P=0.196) was not. Patients treated with atorvastatin had significantly improved adjusted event-free survival rate than controls (hazard ratio 0.52, 95% CI 0.30 to 0.91, P=0.022). CONCLUSION:Diabeticpatients with high plasma levels of non-HDL-C should receive long-term lipid-modifying drugs after PCI to reduce MI and revascularization rates.
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