Zhi Liu1, Yueqiao Xu2, Hengjian Hao1, Chunlin Yin1, Ji Xu1, Jing Li1, Yanling Wang1, Dong Xu3. 1. Division of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China. 2. Division of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing, China. 3. Division of Cardiology, Xuanwu Hospital Capital Medical University, Beijing, China. Electronic address: xwyy168@sina.com.
Abstract
OBJECTIVE: To investigate whether more benefits can be achieved through high intensity atorvastatin compared with moderate intensity atorvastatin in acute coronary syndrome (ACS) patients with diabetes mellitus (DM). METHODS: This was a randomized controlled trail. Total 591 ACS patients with DM who underwent percutaneous coronary intervention were enrolled, 297 in high intensity atorvastatin group (40mg/day) and 294 inmoderate intensity atorvastatin group (20mg/day). The primary end point was one-year incidence of major adverse cardiovascular events (MACE, including cardiovascular death, spontaneous myocardial infarction, unplanned revascularization). Cox proportional hazard regression models were used to analyze the association between clinical endpoints and atorvastatin treatment. RESULTS: At the end of one-year, low-density lipoprotein cholesterol level was lower in high intensity group than in moderate group (1.6±0.6 vs 1.8±0.6, p=0.041). MACE in high intensity group decreased 44.5% than moderate group (8.4% vs. 14.6%, p=0.018). The adjusted hazard ratio (HR) for MACE in patients with atorvastatin 40mg/d was lower compared to patients with atorvastatin 20mg/d (HR [95% CI] 0.61 [0.36 to 0.91], p=0.026). The rates of adverse events were no significantly different between the two groups. CONCLUSIONS: For ACS patients with DM, high intensity atorvastatin induced better long-term outcomes compared with moderate intensity.
RCT Entities:
OBJECTIVE: To investigate whether more benefits can be achieved through high intensity atorvastatin compared with moderate intensity atorvastatin in acute coronary syndrome (ACS) patients with diabetes mellitus (DM). METHODS: This was a randomized controlled trail. Total 591 ACS patients with DM who underwent percutaneous coronary intervention were enrolled, 297 in high intensity atorvastatin group (40mg/day) and 294 in moderate intensity atorvastatin group (20mg/day). The primary end point was one-year incidence of major adverse cardiovascular events (MACE, including cardiovascular death, spontaneous myocardial infarction, unplanned revascularization). Cox proportional hazard regression models were used to analyze the association between clinical endpoints and atorvastatin treatment. RESULTS: At the end of one-year, low-density lipoprotein cholesterol level was lower in high intensity group than in moderate group (1.6±0.6 vs 1.8±0.6, p=0.041). MACE in high intensity group decreased 44.5% than moderate group (8.4% vs. 14.6%, p=0.018). The adjusted hazard ratio (HR) for MACE in patients with atorvastatin 40mg/d was lower compared to patients with atorvastatin 20mg/d (HR [95% CI] 0.61 [0.36 to 0.91], p=0.026). The rates of adverse events were no significantly different between the two groups. CONCLUSIONS: For ACS patients with DM, high intensity atorvastatin induced better long-term outcomes compared with moderate intensity.
Authors: Basmah N Aldosari; Alanood S Almurshedi; Iman M Alfagih; Bushra T AlQuadeib; Mohammad A Altamimi; Syed Sarim Imam; Afzal Hussain; Faleh Alqahtani; Ehab Elzayat; Sultan Alshehri Journal: AAPS PharmSciTech Date: 2021-05-24 Impact factor: 4.026
Authors: Manuel E Machado-Duque; Diego Arturo Garcia; Melissa Hiromi Emura-Vélez; Andrés Gaviria-Mendoza; Jorge E Machado-Alba Journal: J Prim Care Community Health Date: 2021 Jan-Dec