Coronary artery diseasePlasma Triglycerides and Cardiovascular Events in the Treating to New Targets and Incremental Decrease in End-Points Through Aggressive Lipid Lowering Trials of Statins in Patients With Coronary Artery Disease
Section snippets
Methods
The study designs and primary results of the IDEAL and TNT trials have been published.1, 2, 3, 4 TNT was a prospective, double-blind, parallel-group trial with a median follow-up of 4.9 years. IDEAL was a prospective, randomized, open-label, blinded end-point evaluation trial with a median follow-up of 4.8 years. In TNT, 10,001 patients 35 to 75 years of age with clinically evident coronary heart disease and plasma concentrations of low-density lipoprotein (LDL) cholesterol <130 mg/dl (3.4
Results
One year into the trials, 7,232 of 8,888 patients in IDEAL (81.4%) and 8,547 of 10,001 patients in TNT (85.5%) had complete lipid assessments and were eligible for inclusion in the TG analysis. Baseline characteristics and study measurements of lipoprotein variables 1 year into the trials are listed in Table 1. Note that, due to study treatment, LDL cholesterol and apoB were low in the 2 trials.
Data displayed in Figure 1 show that risk of a CVE was higher in patients with TGs >150 than <150
Discussion
The main finding of this post hoc analysis of data from 2 large trials of statin-treated patients was that measurements of plasma TGs allow us to differentiate between levels of risk of recurrence of CVEs, even in patients who have been treated to recommended goals for lowering LDL cholesterol. These results are consistent with those of the Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) trial10; however, unlike that
Acknowledgment
Editorial and graphical support was provided by Paul Lane and Richard Threlfall at UBC Scientific Solutions, Ltd., Horsham, West Sussex, United Kingdom.
References (20)
- et al.
Design and baseline characteristics of the Incremental Decrease in End Points through Aggressive Lipid Lowering study
Am J Cardiol
(2004) - et al.
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) - et al.
Impact of triglyceride levels beyond low-density lipoprotein cholesterol after acute coronary syndrome in the PROVE IT-TIMI 22 trial
J Am Coll Cardiol
(2008) - et al.
Thematic review series: patient-oriented researchWhat we have learned about VLDL and LDL metabolism from human kinetics studies
J Lipid Res
(2006) - et al.
High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial
JAMA
(2005) - et al.
Intensive lipid lowering with atorvastatin in patients with stable coronary disease
N Engl J Med
(2005) - et al.
Enzymatic determination of total serum cholesterol
Clin Chem
(1974) - et al.
A peroxidase-coupled method for the colorimetric determination of serum triglycerides
Clin Chem
(1983) - et al.
Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge
Clin Chem
(1972) - et al.
International Federation of Clinical Chemistry standardization project for measurements of apolipoproteins A-I and BIII. Comparability of apolipoprotein A-I values by use of international reference material
Clin Chem
(1993)
Cited by (0)
The IDEAL and TNT studies were sponsored by Pfizer, Inc., New York, New York.