TNT Trial
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Objective
To compare the efficacy of 10 mg and 80 mg daily dose of atorvastatin in patients with stable CAD and baseline LDL-C between 130 mg/dL and 250 mg/dL.
Methods
The Treating to New Targets (TNT) trial was a randomized trial that enrolled 10,001 patients with stable coronary artery disease to treatment with atorvastatin, 80 or 10 mg/dL, and followed them up for a median period of 4.9 years. The primary end point was a composite of cardiovascular death, myocardial infarction, resuscitated cardiac arrest, and stroke.
Results
Compared to low dose, high dose atorvastatin was associated with:
- A significantly lower mean serum LDL-C concentration (77 vs 101 mg/dL)
- Significant reductions in the rate of the primary end point (8.7 vs 10.9 percent)
- No reduction in all-cause mortality. Higher doses of atorvastatin, although reduced mortality due to cardiac events, were associated with higher mortality rate due to noncardiovascular events.
Conclusion
Wider use of the 80-mg dose of atorvastatin in patients with stable coronary disease is safe, cost-effective, and provides an incremental reduction in coronary events.[1]
References
- ↑ Waters DD (2009). "Clinical insights from the Treating to New Targets trial". Progress in Cardiovascular Diseases. 51 (6): 487–502. doi:10.1016/j.pcad.2009.01.001. PMID 19410683.