IDEAL Subanalysis to Analyze Prevention of HF Post MI

12 Dec, 10

IDEAL Subanalysis to Analyze Prevention of HF Post MI

Background

Atorvastatin 80 mg is superior to simvastatin 20-40 mg in preventing heart failure in patients with MI: Analysis of IDEAL trial

Aim

To evaluate whether intensive LDL lowering with atorvastatin is superior to moderate LDL lowering in preventing heart failure (HF) in patients with myocardial infarction (MI)

Methods

Analysis of Incremental Decrease in End Points Through Aggressive Lipid Lowering (IDEAL) trial

Patients

History of MI (N=8888)

Study Groups

Atorvastatin 80 mg/day (N=4439) vs. simvastatin 20-40 mg/day (N=4449)

Efficacy Outcome

Hospitalization for new or recurrent HF

Median Follow-up Period

4.8 years

Results

Atorvastatin 80 mg yielded significant reduction in hospitalization for new or recurrent HF by 26% vs. simvastatin 20-40 mg (Figure 1)

Figure 1. Incidence of HF hospitalizations in atorvastatin vs. simvastatin recipients

Protection with atorvastatin was also observed when HF was not preceded by MI (Figure 2)

Figure 2. Benefits with atorvastatin in HF not preceded by MI

LDL cholesterol and triglycerides were significantly reduced in atorvastatin recipients (Table)

Table. Comparison of LDL cholesterol and triglycerides in both groups

Conclusion

Intensive LDL cholesterol lowering with atorvastatin 80 mg compared with simvastatin 20 to 40 mg is associated with less frequent new development of HF in patients with MI

Am J Cardiol 2009;103:1381-5

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