methods: tnt study
DESCRIPTION
Prospective, double blind, parallel group trial Completed at 256 sites in 14 countries Between April, 1998, and August, 2004 Median follow-up was 4.9 years Enrolled 10,001 patients aged 35–75 years with clinically evident CAD 5,584 patients had metabolic syndrome - PowerPoint PPT PresentationTRANSCRIPT
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
Methods: Methods: TNT StudyTNT Study
Prospective, double blind, parallel group trial Completed at 256 sites in 14 countries Between April, 1998, and August, 2004 Median follow-up was 4.9 years Enrolled 10,001 patients aged 35–75 years with clinically evident
CAD 5,584 patients had metabolic syndrome 2,820 patients were randomly assigned to receive atorvastatin 10
mg per day 2,764 patients were randomly assigned to receive atorvastatin 80
mg per day Primary outcome measure was time to first major cardiovascular
event, defined as:– Death from coronary heart disease– Non-fatal non-procedure-related myocardial infarction– Resuscitated cardiac arrest– Fatal or non-fatal stroke
Deedwania et al. Lancet 2006;368:919-928.
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
Patients with Major Cardiovascular Patients with Major Cardiovascular Events by Treatment: Events by Treatment: TNT StudyTNT Study
Deedwania et al. Lancet 2006; 368:919-928.
02468
101214161820
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Time to First Major Cardiovascular Event (years)1 2 5 6430
Number at RiskAll Metabolic SyndromeAtv 10 mgAtv 80 mgMetabolic syndrome, no diabetesAtv 10 mgAtv 80 mg
28202764
21912162
27282707
21292118
26442635
20662065
25542561
20042018
24642483
19451967
12491270
9941022
00
00
All metabolic syndromeAtorvastatin 10 mg (n=2820)Atorvastatin 80 mg (n=2764)HR (95% Cl)=0.71 (0.61–0.84)p<0.0001
Metabolic syndrome, no diabetesAtorvastatin 10 mg (n=2191)Atorvastatin 80 mg (n=2162)HR (95% Cl)=0.70 (0.557–0.84)p=0.0002
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
Prevalence of Patients with Major Prevalence of Patients with Major Cardiovascular Events in All TNT Cardiovascular Events in All TNT PatientsPatients
Deedwania et al. Lancet 2006; 368:919-928.
02468
101214161820
Pati
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r Event
(%)
Time to First Major Cardiovascular Event (years)1 2 5 6430
* Hazard ratio for patients with metabolic syndrome and diabetes versus patients without metabolic syndrome or diabetes
† Hazard ratio for patients with metabolic syndrome without diabetes versus patients without metabolic syndrome or diabetes
Metabolic syndrome + diabetes (n=1231)No metabolic syndrome + diabetes (n=270)
Metabolic syndrome, no diabetes (n=4353)No metabolic syndrome,no diabetes (n=4147)
HR (95%Cl)=2.24 (1.87–2.68)*p<0.0001
HR (95%Cl)=1.35 (1.16–1.56) †
p<0.0001
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Patients with Major Cardiovascular Events by Patients with Major Cardiovascular Events by Presence of Metabolic Syndrome Components in Presence of Metabolic Syndrome Components in All TNT PatientsAll TNT Patients
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%)
Metabolic SyndromeMetabolic Syndrome
Deedwania et al. Lancet 2006; 368:919-928.
Number of Metabolic Syndrome Components
Atorvastatin 10 mg
Atorvastatin 80 mg
HR=1.35(0.63–2.90)
HR=0.82(0.57–1.19)
HR=0.95(0.72–1.24)
HR=0.69(0.54–0.89)
HR=0.77(0.60–1.00)
HR=0.68(0.48–0.96)
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
Results: Results: TNT StudyTNT Study
Support the idea that LDL-C lowering greater than LDL-C lowering achieved with standard doses of statins is warranted in patients with CHD and the metabolic syndrome
Also apply to non-diabetic subjects with the metabolic syndrome
Deedwania et al. Lancet 2006;368:919-928.