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Intensive Lipid-Lowering Cuts Risk of Repeat Cardiac Events

Follow-up analyses of PROVE IT-TIMI 22 and IDEAL trials favor high-dose atorvastatin

THURSDAY, Dec. 17 (HealthDay News) -- Follow-up analyses of two studies on intensive versus less intensive lipid-lowering regimens conclude that intensive lipid-lowering is superior for preventing recurrent cardiovascular events, according to two studies in the Dec. 15/22 issue of the Journal of the American College of Cardiology.

Sabina A. Murphy, of Brigham and Women's Hospital in Boston, and colleagues examined the recurrent incidence of death, myocardial infarction, unstable angina, stroke, or revascularization among subjects in the Pravastatin or Atorvastatin Evaluation and Infection Therapy -- Thrombolysis In Myocardial Infarction 22 (PROVE IT-TIMI 22) trial comparing intensive and less intensive lipid-lowering statin regimens. In their follow-up analysis, high-dose atorvastatin (80 mg daily) reduced recurrent events by 19 percent compared to pravastatin (40 mg daily).

Matti J. Tikkanen, M.D., of Helsinki University in Finland, and colleagues analyzed results of the Incremental Decrease in End Points Through Aggressive Lipid Lowering (IDEAL) trial comparing recurrent cardiovascular events with intensive (atorvastatin, 80 mg daily) or less intensive (simvastatin, 20 to 40 mg daily) lipid-lowering regimens. The intensive regimen reduced risk of a first cardiovascular event by 17 percent, a second by 24 percent, a third by 19 percent, a fourth by 24 percent, and a fifth by 28 percent.

"Our results indicate that intensive statin therapy continues to be more effective than standard statin therapy, even beyond the first event, and suggest that clinicians should not hesitate to prescribe high-dose statin therapy for patients experiencing multiple recurrent cardiovascular events," Tikkanen and colleagues conclude.

The Murphy study was supported by Bristol-Myers Squibb, and the Tikkanen study was funded by Pfizer. Several study authors reported receiving speaking and consulting fees from these and several other pharmaceutical companies.

Abstract - Murphy
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Abstract - Tikkanen
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