IDEAL Trial
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Objective
To compare the effects of two lipid lowering strategies (high dose atorvastatin [80 mg] and simvastatin 20 mg) on the risk of cardiovascular disease among patients with a previous myocardial infarction (MI).
Methods
The Incremental Decrease in End Points through Aggressive Lipid Lowering (IDEAL) trial was a prospective, randomized, open-label, blinded end-point evaluation trial which enrolled 8888 patients with past history of acute myocardial infarction, who were randomly assigned to treatment with high dose atorvastatin (80 mg) or simvastatin 20 mg. The primary endpoint was a major coronary event, defined as coronary death, confirmed nonfatal acute MI, or cardiac arrest with resuscitation.
Results
After a median follow-up time of 4.8 years, compared with patients in simvastatin group those in atorvastatin group were associated with:
- Lower mean LDL-C levels (81 vs 104 mg/dL)
- Lowered primary end point rate (9.3% vs 10.4%)
- Lowered occurrence of any coronary event (898 vs 1059)
Conclusion
Intensive lowering of LDL-C did not result in a significant reduction in the primary outcome of major coronary events, but did reduce the risk of other composite secondary end points and nonfatal acute MI. There were no differences in cardiovascular or all-cause mortality.[1][2]
References
- ↑ Pedersen TR, Faergeman O, Kastelein JJ; et al. (2005). "High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial". JAMA : the Journal of the American Medical Association. 294 (19): 2437–45. doi:10.1001/jama.294.19.2437. PMID 16287954. Unknown parameter
|month=ignored (help) - ↑ Pedersen TR, Cater NB, Faergeman O; et al. (2010). "Comparison of atorvastatin 80 mg/day versus simvastatin 20 to 40 mg/day on frequency of cardiovascular events late (five years) after acute myocardial infarction (from the Incremental Decrease in End Points through Aggressive Lipid Lowering [IDEAL] trial)". The American Journal of Cardiology. 106 (3): 354–9. doi:10.1016/j.amjcard.2010.03.033. PMID 20643245. Unknown parameter
|month=ignored (help)