Coronary artery diseaseEffect of Intensive Lipid-Lowering Therapy on Mortality After Acute Coronary Syndrome (a Patient-Level Analysis of the Aggrastat to Zocor and Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis In Myocardial Infarction 22 Trials)
Section snippets
Methods and Results
Study designs and primary reports for the A to Z and PROVE-IT–TIMI 22 trials have been published previously.1, 2, 4, 5 The 2 trials enrolled post-ACS patients and had similar inclusion and exclusion criteria.3 A to Z patients were enrolled <5 days after their presenting events if clinically stable for 12 hours; PROVE-IT–TIMI 22 patients could be enrolled within 10 days if clinically stable for 24 hours. Baseline and on-treatment lipid levels and high-sensitivity C-reactive protein (hs-CRP) were
Discussion
Intensive lipid lowering with high-dose statin therapy after ACS in this analysis of 8,658 patients was associated with reduced mortality compared with moderate lipid lowering with standard-dose statin therapy. On the basis of these findings, 1 death was prevented for every 95 patients treated with high-dose statin therapy for 2 years.
The absolute reduction was from 4.9% in the standard-dose statin therapy group to 3.6% in the high-dose statin therapy group, or a decrease from 158 deaths to 201
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