The new england journal of medicine tufts university. Prove ittimi 22higher dose statin resulted in ldl triglycerides, hdlc, and nonhdlc, and addressing residual risk. Prove it timi 22 tnt ideal search improve it summary nejm jama nejm 2005. Prove ittimi 222 4162 ideal4 8888 tnt3 10,001 mean or median ldlc after treatment ldlcmgdl 95. In addition, in both of these trials, there was even greater. Lessons from the proveit trial higher dose of potent. Prove ittimi 22 compared treatment with pravastatin 40 mgday standard therapy or atorvastatin 80 mg intensive therapy in patients who had been hospitalized for either myocardial infarction mi, with or without evidence of stsegment elevation, or highrisk unstable angina within 10 days prior to enrollment. Prove it timi 22 study 11 shows that as for acute coronary syndrome acs patients who have been treated with statin and whose level of ldlc ittimi 22 trial, any cardiovascular event including revascularization, there was a signi. Publications home of jama and the specialty journals of. Proveit timi 22 tnt ideal search improveit summary nejm jama nejm 2005. The prove ittimi pravastatin or atorvastatin evaluation and.
Ppt the prove it trial powerpoint presentation free to. With a focus on the primary prevention trials, in jupiter, the number needed to treat to prevent one coronary event in 10 years was 66 for those individuals. Myocardial infarction 22 trial presented by ridker et al. Prove it timi 22 4162 patients with acs intervention. Prove ittimi 22 trial ontreatment tg 150 mgdl predicts chd eventsa in patients with acsb adeath, mi, and recurrent acs, batorvastatin 80 mg or pravastatin 40 mg, lipid values are in mgdl acs acute coronary syndrome mi myocardial infarction prove ittimipravastatin or atorvastatin evaluation and infection therapythrombolysis.
The pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 22 prove ittimi 22 trial showed that the use of. Conflicts of interest for this lecture american college of. A prove it timi 22 pravastatin or atorvastatin evaluation and infe. The enzyme has been strongly associated with several cardiovascular risk markers and events. Sep 29, 2006 giraldez rr, giugliano rp, mohanavelu s, murphy sa, mccabe ch, cannon cp, braunwald e. Prove it timi 22 late breaking clinical trials acc 2004. Intensive statin is better than moderate statin post acs prove it timi 22 3. Conflicts of interest for this lecture lilly sanofi novo az pfizer.
Infarction 22 prove ittimi 22 trial was designed to compare the standard degree of ldl cholesterol lowering to approximately 100 mg per deciliter with the use of 40 mg of pravastatin daily 2,3 with. Pdf prognostic utility of apobai, total cholesterolhdl. Early routine vs late provisional use of eptifibatide iv gp iibiiia in nsteacs earlyacs 5. Baseline lowdensity lipoprotein cholesterol is an important predictor of the benefit of intensive lipidlowering therapy. Pleiotropic effects of statins and early benefit in the prove. Pravastatin or atorvastatin evaluation and infection. Creactive protein levels and outcomes after statin therapy. Acute myocardial infarction in patients with st segment elevation. Publications home of jama and the specialty journals of the. Pleiotropic effects of statins and early benefit in the. Prove ittimi 22 pravastatin or atorvastatin evalu ation and. Prove ittimi 22 trial overview1 a multicenter randomized treatmentcontrolled trial to determine lipid lowering effects of high dose atorvastatin vs. Prove ittimi 22 compared treatment with pravastatin 40 mgday standard therapy or atorvastatin 80 mg intensive therapy in patients who had. After adjusting for ldl and crp, crp explained residual benefit associated with atorva deathmi from.
Acute myocardial infarction in patients with st segment. Prove ittimi 22 pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 22 a to z trial sage study assessing goals in the elderly trial of 3086 patients whose mean age was 65but in which no specific subgroup analysis of elderly patients was done. Identify and prioritize the significant active and inactive medical problems. Prove ittimi 22 pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 22 rbbb right bundle branch block rpa reteplase riflesteacs radial vs. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. Prove it timi 22 translated into a 16% reduction in the hazard ratio in favor of atorvastatin p0. The other study, the alliance trial, was a comparison of.
Prove it timi 22 compared treatment with pravastatin 40 mgday standard therapy or atorvastatin 80 mg intensive therapy in patients who had been hospitalized for either myocardial infarction. Reduction in recurrent cardiovascular events with intensive lipidlowering statin therapy compared with moderate lipidlowering statin therapy after acute coronary syndromes from the prove ittimi 22 pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction. Prove ittimi 22 study 11 shows that as for acute coronary syndrome acs patients who have been treated with statin and whose level of ldlc ittimi 22 trial, any cardiovascular event including revascularization, there was a signi. Comparison of intensive and moderate lipid lowering with statins after acute coronary syndromes prove ittimi 22. Acute coronary syndromes statins in elderly patients. Genomic and genetic medicine in the clinical setting. Risks, benefits and current management strategies of statin. All main analyses were prespecified in the prove ittimi 22 prot ocol.
An overview of prove ittimi 22 a comparison of intensive statin therapy and moderate statin therapy in acute coronary syndrome patients. Correspondingly, the number needed to treat to reduce coronary heart disease events with statin therapy di. Lessons from the proveit trial higher dose of potent statin. With a focus on the primary prevention trials, in jupiter, the number needed to treat to prevent. Pravastatin or atorvastatin evaluation and infection therapy prove it timi 22 trial. Effect of intensive statin therapy on clinical outcomes among.
He undergoes coronary angiography and has a drug eluting stent placed to his left anterior descending artery. Giraldez rr, giugliano rp, mohanavelu s, murphy sa, mccabe ch, cannon cp, braunwald e. The prove ittimi 22 trial evaluated 4,162 patients hospitalized for acs. National cholesterol education program adult treatment panel iii guidelines. Prasugrel in acs treated with pci triton timi 38 4. The association of cardiovascular events with lppla2 has been studied continuously today. Acute coronary syndromes statins in elderly patients with. Onscreen show a free powerpoint ppt presentation displayed as a flash slide show on id. Request pdf on sep 1, 2006, andrea poli and others published pleiotropic effects of statins and early benefit in the prove ittimi22 study find, read and cite all the research you need on. Effect of intensive statin therapy on clinical outcomes among patients undergoing percutaneous coronary intervention for acute coronary syndrome. The investigators and research coordinators who participated in the pravastatin or atorvastatin evaluation and infection therapy thrombolysis in myocardial infarction 22 prove it timi 22.
Association between triglyceride lowering and reduction of. The pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 22 prove ittimi 22 trial showed that. Intensive versus moderate lipid lowering with statins. Reduction in recurrent cardiovascular events with intensive lipidlowering statin therapy compared with moderate lipidlowering statin therapy after acute coronary syndromes from the prove it timi 22 pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 22 trial. Medicaid update new york state department of health. A matter of perspective david huggar, pharmd masters of pharmacotherapy candidate the university of texas at austin college of pharmacy pharmacotherapy education and research center university of texas health science center at san antonio learning objectives 1. Jupiter and proveit timi 22 were prospective clinical trials involving use of rosuvastatin and placebo, and pravastatin and atorvastatin, respectively. Intensive statin is better than moderate statin post acs prove ittimi 22 3. Identify which of the above problems require drug therapy. Effect of intensive statin therapy on clinical outcomes. Prove ittimi 22 40 mg 80 mg 10 125 acs patients since br is a kif6 noncarrier, she may be motivated to adhere to a healthy lifestyle to lower her chd event risk in published studies about kif6, chd events include but were not limited to heart attack, stroke and plaque build up in arteries requiring stent replacement. Prove it timi 22 trial ontreatment tg 150 mgdl predicts chd eventsa in patients with acsb adeath, mi, and recurrent acs, batorvastatin 80 mg or pravastatin 40 mg, lipid values are in mgdl acs acute coronary syndrome mi myocardial infarction prove it timipravastatin or atorvastatin evaluation and infection therapythrombolysis.
Reduction in recurrent cardiovascular events with intensive. Timi 28 and enoxaparin extracttimi 25 as adjuncts to fibrinolysis for stemi 2. An overview of prove ittimi 22 a comparison of intensive. Implications of recent clinical trials for the national cholesterol education program adult treatment panel iii guidelines. An overview of ideal a comparison of intensive statin vs. Linear relationship between levels crp achieved after statin therapy and risk reduction of mideath.
Risk in statin takers with ldlc prove it timi 22 trial investigators background aggressive blood pressure bp control has been advocated in patients with acute coronary syndrome, but few data exist in this population relative to cardiovascular outcomes. Atorva 80 16% reduction in death from any cause, mi, unstable angina, revascularization, and stroke tnt 10,001 patients with stable chd intervention. Impact of triglyceride levels beyond lowdensity lipoprotein. Prove ittimi 22 showed that in patients with acute coronary syndromes, aggressive lipidlowering using atorvastatin 80 mgday provided greater protection against death or major cardiovascular events than did moderate lipidlowering using pravastatin 40 mgday. Its discovery was directly related to the hydrolysis of the plateletactivating factor and oxidized phospholipids, which are considered protective functions.
Early and late benefits of highdose atorvastatin in patients with. Prognostic utility of apobai, total cholesterolhdl, nonhdl cholesterol, or hscrp as predictors of clinical risk in patients receiving statin therapy after acute coronary syndromes. Outcomes were compared in 2,868 patients who underwent pci for acs just prior to enrollment in the prove ittimi 22 pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 22 trial, which randomized patients to either atorvastatin 80 mg or pravastatin 40 mg daily. Prove ittimi 22 compared the efficacy of atorvastatin vs. Journal of american college of cardiology 2008 feb. Proveit timi 22 4162 patients with acs intervention. Prove ittimi 22 atorva 80mg vs prava 40mg in 4162 acs patients. Antioxidant and inflammatory aspects of lipoprotein. Atorvastatin 62 mgdl pravastatin 95 mgdl p ittimi 22 trial, which looked at whether intensive ldl lowering with atorvastatin produced greater reductions in clinical events than standard ldl cholesterol lowering with pravastatin, in patients presenting with acute coronary artery syndromes. Lessons from the proveit trial higher dose of potent statin better for highrisk patients interpreting key trials abstract the pravastatin or atorvastatin evaluation and infection therapy trial prove ittimi 22 showed that in patients with acute coronary syndromes, aggressive lipidlowering using atorvastatin 80 mgday provided greater. Implications of recent clinical trials for the national. Miller m, cannon cp, murphy sa, qin j, ray kk, braunwald e. Pravastatin or atorvastatin evaluation and infection therapy. Landmark clinical trials national lipid association.
Femoral randomized investigation in st elevation acute coronary syndrome rival radial vs. Atorva 80 significant reductions in primary endpoint of major cardiovascular event defined as death from chd, nonfatal. Lipid results median starting ldlc was 106 mgdl median treated ldlc values were. In the pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 22 prove ittimi 22 and the incremental decrease in end points through aggressive lipid lowering ideal trials, analyses demonstrated that lower ldlc achieved with highintensity statins reduced both the first cardiovascular event as. Infarction 22 prove it timi 22 trial was designed to compare the standard degree of ldl cholesterol lowering to approximately 100 mg per deciliter with the use of 40 mg of pravastatin daily 2,3 with more intensive ldl cholesterol lowering to approximately 70 mg per deciliter 1. Conflicts of interest for this lecture lilly sanofi novo az pfizer cardiometabolic companies. Risks, benefits and current management strategies of. Impact of triglyceride levels beyond lowdensity lipoprotein cholesterol after acute coronary syndrome in the prove ittimi 22 trial. Proveit timi 22pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 2245 synergysuperior yield of the new strategy of enoxaparin, revascularization, and glycoprotein iibiiia inhibitors34 tacticstreat. Proveit timi 22pravastatin or atorvastatin evaluation and infection therapythrombolysis in myocardial infarction 2245 synergysuperior yield of the new strategy of enoxaparin, revascularization, and glycoprotein iibiiia inhibitors34 tacticstreat angina with aggrastat and determine cost of.