American Journal of Cardiology
Volume 100, Issue 5 , Pages 747-752 , 1 September 2007

Safety and Efficacy of Atorvastatin-Induced Very Low-Density Lipoprotein Cholesterol Levels in Patients With Coronary Heart Disease (a Post Hoc Analysis of the Treating to New Targets [TNT] Study)†

  • John C. LaRosa, MD

      Affiliations

    • State University of New York Health Science Center, New York, New York
    • Corresponding Author InformationCorresponding author: Tel: 718-270-2611; fax: 718-270-4732.
    • ,
  • Scott M. Grundy, MD, PhD

      Affiliations

    • University of Texas Southwestern Medical Center, Dallas, Texas
    • ,
  • John J.P. Kastelein, MD

      Affiliations

    • Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    • ,
  • John B. Kostis, MD

      Affiliations

    • University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey
    • ,
  • Heiner Greten, MD

      Affiliations

    • Hanseatisches Herzzentrum Hamburg, Hamburg, Germany.
    • ,
  • Treating to New Targets (TNT) Steering Committee and Investigators

Received 10 January 2007 ,Revised 28 March 2007 ,Accepted 28 March 2007.

References 

  1. LaRosa JC, Grundy SM, Waters DD, Shear C, Barter P, Fruchart JC, et al. Treating to New Targets (TNT) Investigators (Intensive lipid lowering with atorvastatin in patients with stable coronary disease). N Engl J Med. 2005;352:1425–1435
  2. Waters DD, Guyton JR, Herrington DM, McGowan MP, Wenger NK, Shear C TNT Steering Committee Members and Investigators. Treating to New Targets (TNT) study: does lowering low-density lipoprotein cholesterol levels below currently recommended guidelines yield incremental clinical benefit?. Am J Cardiol. 2004;93:154–158
  3. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002;360:7–22
  4. Cannon CP, Braunwald E, McCabe CH, Rader DJ, Rouleau JL, Belder R, et al. Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction 22 Investigators (Comparison of intensive and moderate lipid lowering with statins after acute coronary syndromes). N Engl J Med. 2004;350:1495–1504
  5. Schwartz GG, Olsson AG, Ezekowitz MD, Ganz P, Oliver MF, Waters D, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA. 2001;285:1711–1718
  6. de Lemos JA, Blazing MA, Wiviott SD, Lewis EF, Fox KA, White HD, et al Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial. JAMA. 2004;292:1307–1316
  7. Sever PS, Dahlof B, Poulter NR, Wedel H, Beevers G, Caulfield M, et al Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003;361:1149–1158
  8. Colhoun HM, Betteridge DJ, Durrington PN, Hitman GA, Neil HA, Livingstone SJ, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet. 2004;364:685–696
  9. Pedersen TR, Faergeman O, Kastelein JJP, Olsson AG, Tikkanen MJ, Holme I, et al. Incremental Decrease in End Points Through Aggressive Lipid Lowering (IDEAL) Study Group. High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction. The IDEAL study: a randomized clinical trial. JAMA. 2005;294:2437–2445
  10. Taylor AJ, Kent SM, Flaherty PJ, Coyle LC, Markwood TT, Vernalis MN. ARBITER: Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol: a randomized trial comparing the effects of atorvastatin and pravastatin on carotid intima medial thickness. Circulation. 2002;106:2055–2060
  11. Nissen SE, Tuzcu EM, Schoenhagen P, Brown BG, Ganz P, Vogel RA, et al Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA. 2004;291:1071–1080
  12. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–1278
  13. Jacobs D, Blackburn H, Higgins M, Reed D, Iso H, McMillan G, et al Report of the Conference on Low Blood Cholesterol: mortality associations. Circulation. 1992;86:1046–1060
  14. Kritchevsky SB. Dietary lipids and the low blood cholesterol-cancer association. Am J Epidemiol. 1992;135:509–520
  15. Cummings P, Psaty BM. The association between cholesterol and death from injury. Ann Intern Med. 1994;120:848–855
  16. Wiviott SD, Cannon CP, Morrow DA, Ray KK, Pfeffer MA, Braunwald E PROVE IT-TIMI 22 Investigators. Can low-density lipoprotein be too low? The safety and efficacy of achieving very low-density lipoprotein with intensive statin therapy. A PROVE IT-TIMI 22 substudy. J Am Coll Cardiol. 2005;46:1411–1416
  17. Pitt B. Low-density lipoprotein cholesterol in patients with stable coronary heart disease—is it time to shift our goals?. N Engl J Med. 2005;352:1483–1484

 The Treating to New Targets study was funded by Pfizer, Inc., New York, New York.

PII: S0002-9149(07)00990-3

doi: 10.1016/j.amjcard.2007.03.102

American Journal of Cardiology
Volume 100, Issue 5 , Pages 747-752 , 1 September 2007

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