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LC FP
Fri, Apr-18-08, 16:25
Once I start I can't stop. Not saying where this is from..

Treatment with atorvastatin 80 mg/day significantly reduces the risk of major cardiovascular events compared with atorvastatin 10 mg/day in women as well as men with stable coronary heart disease, according to a report in the April issue of Heart.

The Treating to New Targets (TNT) study already showed that further reducing LDL cholesterol by increasing the atorvastatin dose to 80 mg daily provided significant clinical benefit beyond treatment with atorvastatin 10 mg daily, the authors explain.

Dr. N. K. Wenger from Emory University School of Medicine, Atlanta, Georgia and colleagues sought to determine whether the benefits of intensive versus standard levels of lipid lowering are equally applicable to women. Some 10,000 patients, including 1902 women, with stable CHD were randomized to atorvastatin 10 mg/day or 80 mg/day for a median follow-up of 4.9 years.

The relative and absolute reductions in the rate of major cardiovascular events associated with intensification of atorvastatin treatment were 27% and 2.7%, respectively, in women, the authors report, compared with 21% and 2.2% reductions, respectively, in men.

The number needed to treat (NNT) to prevent one cardiovascular event during 4.9 years of treatment with atorvastatin 80 mg versus atorvastatin 10 mg would be 29 for women and 30 for men, the researchers note.

In women, there was an excess of total deaths in the atorvastatin 80 mg group compared with the atorvastatin 10 mg group, the investigators say, but this excess was the result of an excess of non-cardiovascular deaths limited to an increase in cancer mortality.

"The fact that no single cause of death by body system and no single cancer type contributed disproportionately to the difference in non-cardiovascular mortality between treatment groups, and that there was no difference between groups in new cancer diagnoses or adverse events associated with cancer, lend further support to the possibility that this represents a chance finding," Dr. Wenger and colleagues explain.

"Among women with stable coronary heart disease, reduction of LDL cholesterol levels to well below currently recommended targets with atorvastatin 80 mg produced significant reductions in risk for major cardiovascular events compared with atorvastatin 10 mg," the researchers conclude.

"More data are needed to clarify the effects of aggressive lipid-lowering treatment on cardiovascular versus non-cardiovascular mortality in these women," they add. "The data from the current study do not provide compelling evidence of a favorable or adverse effect of aggressive lipid lowering on total mortality in women."

LessLiz
Fri, Apr-18-08, 16:33
http://heart.bmj.com/cgi/content/abstract/94/4/434

Beneficial effects of aggressive low-density lipoprotein cholesterol lowering in women with stable coronary heart disease in the Treating to New Targets (TNT) study
N K Wenger1, S J Lewis2, F K Welty3, D M Herrington4, V Bittner on behalf of the TNT Steering Committee and Investigators5

1 Emory University School of Medicine, Atlanta, GA, USA
2 Northwest Cardiovascular Institute, Portland, OR, USA
3 Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
4 Wake Forest University School of Medicine, Winston-Salem, NC, USA
5 University of Alabama at Birmingham, Birmingham, AL, USA

Correspondence to:
Professor N K Wenger, Emory University School of Medicine, 49 Jesse Hill Jr Drive, SE Atlanta, GA 30303, USA; nwenger~emory.edu

Objective: To examine by secondary analysis of the Treating to New Targets (TNT) study whether the benefits of intensive versus standard levels of lipid lowering are equally applicable to women.

Methods: A total of 10 001 patients (1902 women) with stable coronary heart disease (CHD) were randomised to double-blind treatment with atorvastatin 10 or 80 mg/day for a median follow-up of 4.9 years.

Results: In women and men, intensive treatment with atorvastatin 80 mg significantly reduced the rate of major cardiovascular events compared with atorvastatin 10 mg. Among women, the relative and absolute reductions were 27% and 2.7%, respectively (hazard ratio (HR) = 0.73, 95% confidence interval (CI) 0.54 to 1.00, p = 0.049). In men, the corresponding rate reductions were 21% and 2.2% (HR = 0.79, 95% CI 0.69 to 0.91, p = 0.001). The number needed to treat value (to prevent one cardiovascular event over 4.9 years compared with patients treated with atorvastatin 10 mg) for atorvastatin 80 mg was 29 for women and 30 for men. Rates of death of non-cardiovascular origin in the atorvastatin 80 mg and atorvastatin 10 mg were 3.6% and 1.6%, respectively (p = 0.004) among women, and 2.8% and 3.1% (p = 0.47) among men.

Conclusion: Intensive lipid-lowering treatment with atorvastatin 80 mg produced significant reductions in relative risk for major cardiovascular events compared with atorvastatin 10 mg in both women and men with stable CHD.

Somehow, I doubt the headlines will ever scream that the death rate among women was 225% higher.