Slide Source: Lipids Online Slide Library www.lipidsonline.org Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT): Design Cannon CP.

Slides:

Advertisements

Similar presentations

Gemfibrozil for the Secondary Prevention of Coronary Heart Disease in Men with Low Levels of High-Density Lipoprotein Cholesterol VA-HIT Rubins, HB, et.

Advertisements

Secretory Phospholipase A2: A New Risk Factor and Soon a New Target of Therapy Rabih R. Azar, MD, MSc, FACC Associate Professor of Medicine Division of.

1 CAMELOT: Study Design A Morbidity and Mortality Study Patients with documented CAD on standard-of-care therapies* (n=1997) Clinical events (morbidity.

Coronary heart disease (CHD) event rates in secondary prevention and acute coronary syndrome trials A. Kumar, C.P. Cannon. Arch Med Sci 2007;3:S115-S125.

THE ACTION TO CONTROL CARDIOVASCULAR RISK IN DIABETES STUDY (ACCORD)

1. 2 The primary Objective of IDEAL LDL-C Simvastatin mg/d Atorvastatin 80 mg/d risk CHD In stable CHD patients IDEAL: The Incremental Decrease.

Lipid Disorders and Management in Diabetes

Prescribing Information is available at the end of this presentation NHS Surrey Lipid Guidelines Dr Adam Jacques Ashford & St.

TNT: Study Design Treating to New Targets 2 5 years 10,001 Patients Clinically evident CHD LDL-C 130  250 mg/dL following up to 8-week washout and 8-week.

The Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) The LIPID Study Group N Engl J Med 1998;339:

Cholesterol quintile (mg/dL)

Slide Source: Lipids Online Slide Library Heart and Estrogen/progestin Replacement Study (HERS) and HERS II: Secondary Prevention.

Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia James Shepherd, M.D., Stuart M. Cobbe, M.D., Ian Ford, Ph.D., Christopher.

Slide Source: Lipids Online Slide Library Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) 5804 patients aged 70–82.

How Aggressive do we get on Lipids? Christopher Cannon, M.D. Senior Investigator, TIMI Study Group Cardiovascular Division, Brigham and Women’s Hospital,

TC LDL- C HDL- C Nonfatal MI/CHD death CHD death All- cause mortality *As compared to placebo. † P= CARE: Effect of Lipid Lowering on Lipid Values.

LIPID LOWERING IN T2D (The Lower the Better?) CONS… TARGETING HARD CVD END POINTS Charles SAAB MD Consultant Endocrinologist DCRP Sacre-Coeur University.

VBWG IDEAL: The Incremental Decrease in End Points Through Aggressive Lipid Lowering Study.

Slide Source: Lipids Online Slide Library Prospective Pravastatin Pooling Project: Coronary Event Rates in CARE and LIPID Patients.

(N=488) Simvastatin in Patients With Prior Cerebrovascular Disease: HPS *29% RRR, p=0.001 Heart Protection Study Collaborative Group. Lancet. 2004;363:

Diabetes Trials Unit University of Oxford WebSite: Lipids in Diabetes Study.

* Plus–minus values are means ±SD. † Race was determined by the investigator. ‡ The body-mass index is the weight in kilograms divided by the square of.

ASTEROID A Study To evaluate the Effect of Rosuvastatin On Intravascular ultrasound- Derived coronary atheroma burden.

Clinical experience with ezetimibe/simvastatin in a Mediterranean population The SETTLE Study I. Migdalis a, A. Efthimiadis b, St. Pappas c, D. Alexopoulos.

HYPERLIPIDAEMIA. 4S 4444 patients –Hx angina or MI –Cholesterol Simvastatin 20mg (10-40) vs. placebo FU 5 years  total cholesterol 25%;  LDL.

COURAGE: Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation Purpose To compare the efficacy of optimal medical therapy (OMT)

Slide Source: Lipids Online Slide Library Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)

VBWG CHARISMA Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance trial.

Clinical Outcomes with Newer Antihyperglycemic Agents

0902CZR01NL537SS0901 RENAAL Altering the Course of Renal Disease in Hypertensive Patients with Type 2 Diabetes and Nephropathy with the A II Antagonist.

Fenofibrate Intervention and Event Lowering in Diabetes FIELDFIELD Presented at The American Heart Association Scientific Sessions, November 2005 Presented.

VBWG HPS. Lancet. 2003;361: Gæde P et al. N Engl J Med. 2003;348: Recent statin trials: Reduction in primary outcome in patients with diabetes.

Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Trial MEGA Trial Presented at The American Heart Association.

Slide Source: Lipids Online Slide Library Collaborative Atorvastatin Diabetes Study (CARDS) Type 2 diabetes mellitus Men and women.

Laura Mucci, Pharm.D. Candidate Mercer University 2012 Preceptor: Dr. Rahimi February 2012.

Incremental Decrease in Clinical Endpoints Through Aggressive Lipid Lowering (IDEAL) Trial IDEAL Trial Presented at The American Heart Association Scientific.

The Prospective Pravastatin Pooling Project L I P I D CARECARE PPP Project Investigators Am J Cardiol 1995; 76:899–905.

Aim To determine the effects of a Coversyl- based blood pressure lowering regimen on the risk of recurrent stroke among patients with a history of stroke.

WOSCOPS: West Of Scotland Coronary Prevention Study Purpose To determine whether pravastatin reduces combined incidence of nonfatal MI and death due to.

SATURN: Objective To compare the effects of rosuvastatin 40 mg versus atorvastatin 80 mg on progression of coronary atherosclerosis assessed by intravascular.

SPARCL Stroke Prevention by Aggressive Reduction in Cholesterol Levels trial.

LIPID: Long-term Intervention with Pravastatin in Ischemic Disease Purpose To determine whether pravastatin will reduce coronary mortality and morbidity.

VBWG PROactive: Study design Dormandy JA et al. Lancet. 2005;366: Charbonnel B et al. Diabetes Care. 2004;27: Objective: Assess the effects.

Slide Source: Lipids Online Slide Library LDL Cholesterol, mg/dL Years of Follow-up Ridker PM et al. N Engl J Med 2002;347:1557–1565.

ASCOT and Steno-2: Aggressive risk reduction benefits two different patient populations *Composite of CV death, nonfatal MI or stroke, revascularization,

Collaborative Atorvastatin Diabetes Study CARDS Dr Sachin Kadoo.

Slide Source: Lipids Online Slide Library ASTEROID Population at Baseline (n=507) Patients Completing (n=349) Patients Not Completing.

VBWG BRAVER Trial BRachial Artery Vascular Endothelium Reactivity Study A substudy of PROVE IT-TIMI 22.

Diabetes Prevention Program (DPP)

BRIAN CLAYTON INTERNAL MEDICINE ADVISOR: ANNA MAE SMITH PRECEPTOR: DR. RAJESH PATEL Evidence Based Medicine Spring 2009.

Slide Source: Lipids Online Slide Library C-Reactive Protein, Metabolic Syndrome, and Risk for CV Events: Women’s Health Study 14,719.

Slide Source: Lipids Online Slide Library Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Design Sever PS et al. J Hypertens 2001;19:1139–1147.

Clinical Outcomes with Newer Antihyperglycemic Agents FDA-Mandated CV Safety Trials 1.

Secretory Phospholipase A 2 Inhibition with Varespladib and Cardiovascular Events in Patients with an Acute Coronary Syndrome: Results of the VISTA-16.

Downloaded from Slide 1 Dual Inhibition of Two Sources of Cholesterol: Absorption and Production Results of a Clinical Trial.

Slide Source: Lipids Online Slide Library Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) Nissen SE et al. JAMA.

The JUPITER Trial Reference Ridker PM. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195–2207.

Double-blind, randomized trial in 4,162 patients with Acute Coronary Syndrome

Over Time Additional Risk Factors Can Progress: Effect of Cholesterol and BP on CHD Risk in MRFIT Trial

FOURIER Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk

Impact of Triglyceride Levels Beyond Low-Density Lipoprotein Cholesterol After Acute Coronary Syndrome in the PROVE IT-TIMI 22 Trial Michael Miller MD,

European Society of Cardiology 2017 Clinical Trial Update I

First time a CETP inhibitor shows reduction of serious CV events

SPIRE Program: Studies of PCSK9 Inhibition and the Reduction of Vascular Events Unanticipated attenuation of LDL-c lowering response to humanized PCSK9.

TNT: Baseline and final LDL cholesterol levels

FOURIER Trial design: Patients with established cardiovascular disease on statin therapy were randomized to evolocumab 140 mg subcutaneous every 2 weeks.

Potential mechanisms whereby statins may reduce the risk of stroke

The Heart Rhythm Society Meeting Presented by Dr. Johan De Sutter

PROSPER: trial design

SPIRE Program: Studies of PCSK9 Inhibition and the Reduction of Vascular Events Unanticipated attenuation of LDL-c lowering response to humanized PCSK9.

Presentation transcript:

Slide Source: Lipids Online Slide Library Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT): Design Cannon CP et al. N Engl J Med 2004;350: patients hospitalized for ACS within previous 10 days, TC 240 mg/dL (200 mg/dL if on lipid Rx) Randomized to pravastatin 40 mg (standard therapy) or atorvastatin 80 mg (intensive therapy) Primary endpoint: composite of death, MI, unstable angina requiring rehospitalization, revascularization (at least 30 days after randomization), and stroke Follow-up: 18–36 months (mean, 24)

Slide Source: Lipids Online Slide Library PROVE IT: Baseline Characteristics Mean ± SD, n (%), or median (interquartile range) Pravastatin 40 mg (n=2063) Atorvastatin 80 mg (n=2099) Age, yr 58.3 ± ± 11.2 Male sex1617 (78.4)1634 (77.8) White race1865 (90.4)1911 (91.0) Diabetes361 (17.5)373 (17.8) Hypertension1014 (49.2)1077 (51.3) Current smoker766 (37.1)763 (36.4) Peripheral arterial disease [p=.03]136 (6.6)105 (5.0) Total cholesterol, mg/dL180 (158–202)181 (160–205) LDL-C, mg/dL106 (87–127)106 (89–128) HDL-C, mg/dL39 (33–46)38 (32–46) Triglycerides, mg/dL154 (115–207)158 (119–214) Prior statin therapy514 (24.9)535 (25.5) Cannon CP et al. N Engl J Med 2004;350: Adapted with permission. Copyright © 2004 Massachusetts Medical Society. All rights reserved.

Slide Source: Lipids Online Slide Library PROVE IT: Lipid and CRP Changes Change from Baseline, % Pravastatin 40 mg Atorvastatin 80 mg p<.001 Cannon CP et al. N Engl J Med 2004;350: CRPHDL-CLDL-C p<.001 p<.001 –10.4 – –82.9 –89.4

Slide Source: Lipids Online Slide Library PROVE IT: LDL-C Achieved Median LDL-C, mg/dL Baseline Cannon CP et al. N Engl J Med 2004;350: Pravastatin 40 mg Atorvastatin 80 mg p<.001

Slide Source: Lipids Online Slide Library PROVE IT: Effect on CRP Median CRP, mg/L Baseline Cannon CP et al. N Engl J Med 2004;350: Pravastatin 40 mg Atorvastatin 80 mg p<.001

Slide Source: Lipids Online Slide Library Pravastatin 40 mg Atorvastatin 80 mg PROVE IT: Primary and Secondary Endpoints Kaplan–Meier Event Rate, % Cannon CP et al. N Engl J Med 2004;350: 14%, p=.029 16%, p= ° endpoint: death, MI, unstable angina, revascularization, stroke 2° endpoint: CHD death, MI, revascularization

Slide Source: Lipids Online Slide Library Reduction in Death or Major Cardiovascular Event with Intensive Statin Therapy Death or Major Cardiovascular Event, % No. at Risk Pravastatin Atorvastatin Months of Follow-up mg of pravastatin 80 mg of atorvastatin Cannon CP et al. N Engl J Med 2004;350: Copyright © 2004 Massachusetts Medical Society. All rights reserved.