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Odkazy a zdroje - Studie - AVERT



AVERT

Atorvastatin Versus Revascularisation Treatments

Author(s)
(a) McCormick LS, Black D, Waters D, Brown WV, Pitt B, and the AVERT Investigators
(b) Pitt B, Waters D, Brown WV, van Boven AJ, Schwartz L, Title LM, Eisenberg D, Shurzinske L, McCormick LS, and the Atorvastatin versus Revascularization Treatment Investigators
(c) Waters D, Pitt B, Brown WV, MacDougall D, McCormick LS, Black D

Title(s)
(a) Rationale, design, and baseline characteristics of a trial comparing aggressive lipid lowering with Atorvastatin Versus Revascularisation Treatments (AVERT)
(b) Aggressive lipid-lowering therapy compared with angioplasty in stable coronary artery disease
(c) Aggressive lipid lowering versus coronary angioplasty in subgroups of the AVERT trial: post hoc analyses

Reference(s)
(a) Am J Cardiol 1997;80:1130-3
(b) N Engl J Med 1999;341:70-6
(c) Eur Heart J 1999;20 Suppl:478

Disease
Ischaemic heart disease and stable angina pectoris

Purpose
To compare the efficacy of aggressive lipid-lowering therapy with percutaneous coronary revascularisation (angioplasty or other catheter-based procedures) in the treatment of significant coronary artery disease

Study design
Randomised, open

Follow-up
18 months

Patients
341 patients (164 atorvastatin, aged 59 ± 0.8 years; 177 revascularisation, aged 58 ± 0.6 years) with asymptomatic or mild to moderate angina, LDL cholesterol ≥ 115 mg/dl and at least one defined narrowing of a major coronary artery

Treatment regimen
Atorvastatin, 80 mg/day after discontinuation of any previous lipid-lowering agents, or revascularisation by the recommended procedure

Concomitant therapy
Daily aspirin plus optimal antiangina therapy

Results
Lovastatin reduced LDL cholesterol by 25% to 2.96 mmol/l and increased HDL cholesterol by 6% to 1.02 mmol/l. It also significantly reduced the incidence of first major acute coronary events (183 vs 116 first events, relative risk 0.63; p < 0.001), MI (95 vs 57 events, relative risk 0.60; p = 0.002), unstable angina (87 vs 60 first events, relative risk 0.68; p = 0.02), coronary revascularisation procedures (157 vs 106 procedures, relative risk 0.67; p = 0.001), coronary events (215 vs 163 events, relative risk 0.75; p = 0.006) and cardiovascular events (255 vs 194 events, relative risk 0.75; p = 0.003)