Intensive versus moderate lipid lowering with statins after acute coronary syndromes
Intensive versus moderate lipid lowering with statins after acute coronary syndromes
复制标题
DOI：
10.1056/nejmoa040583
复制
发表时间：
2004-04-08
影响因子：
158.5
通讯作者：
Skene, AM
中科院分区：
文献类型：
--
作者：
Cannon, CP;Braunwald, E;Skene, AM
背景：他汀类药物降脂治疗可降低心血管事件的风险，但低密度脂蛋白（LDL）胆固醇的最佳水平尚不清楚。方法：我们纳入了4162例在前10天内因急性冠状动脉综合征住院的患者，并将普伐他汀每日40 mg（标准治疗）与阿托伐他汀每日80 mg（强化治疗）进行比较。主要终点为全因死亡、心肌梗死、需要再次住院治疗的记录不稳定型心绞痛、血运重建（在随机化后至少30天进行）和卒中的复合终点。本研究旨在确定普伐他汀与阿托伐他汀相比在至终点事件时间方面的非劣效性。随访18 ~ 36个月（平均24个月）。结果：标准剂量普伐他汀组LDL胆固醇水平中位数为95 mg/dl（2.46 mmol/L），高剂量阿托伐他汀组为62 mg/dl（1.60 mmol/L）（P
BACKGROUND:Lipid-lowering therapy with statins reduces the risk of cardiovascular events, but the optimal level of low-density lipoprotein (LDL) cholesterol is unclear.METHODS:We enrolled 4162 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and compared 40 mg of pravastatin daily (standard therapy) with 80 mg of atorvastatin daily (intensive therapy). The primary end point was a composite of death from any cause, myocardial infarction, documented unstable angina requiring rehospitalization, revascularization (performed at least 30 days after randomization), and stroke. The study was designed to establish the noninferiority of pravastatin as compared with atorvastatin with respect to the time to an end-point event. Follow-up lasted 18 to 36 months (mean, 24).RESULTS:The median LDL cholesterol level achieved during treatment was 95 mg per deciliter (2.46 mmol per liter) in the standard-dose pravastatin group and 62 mg per deciliter (1.60 mmol per liter) in the high-dose atorvastatin group (P