slide source: lipids online slide library anglo-scandinavian cardiac outcomes trial (ascot) design...
DESCRIPTION
Slide Source: Lipids Online Slide Library mg/dl TC Baseline1 Year LDL-CHDL-C ASCOT: Lipid Changes with Atorvastatin Sever PS et al. Lancet 2003;361:1149–1158. Reprinted with permission from Elsevier Science. TG 3 YearsTRANSCRIPT
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
Anglo-Scandinavian Cardiac Outcomes Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) DesignTrial (ASCOT) Design
Sever PS et al. J Hypertens 2001;19:1139–1147. | Sever PS et al. Lancet 2003;361:1149–1158.
Multicenter trial with 2 treatment comparisons A prospective, randomized, open, blinded endpoint (PROBE)
design comparing 2 antihypertensive regimens in hypertensive men and women without known CHD who had 3 other CV risk factors (n=19,342)
A double-blind, placebo-controlled trial of atorvastatin 10 mg/d in the subsample of patients with total cholesterol 250 mg/dL (n=10,305)
Primary endpoint: nonfatal MI (including silent MI) or CHD death Planned follow-up average of 5 yr; lipid-lowering arm stopped
early at median follow-up of 3.3 yr
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
ASCOT Entry CriteriaASCOT Entry Criteria
Sever PS et al. J Hypertens 2001;19:1139–1147. | Sever PS et al. Lancet 2003;361:1149–1158.
No treated angina or prior MI Age: 40–79 yr Blood pressure
Untreated: SBP 160 and/or DBP 100 mm Hg Treated: SBP 140 and/or DBP 90 mm Hg
3 CV risk factors: Smoking ECG abnormalities LVH NIDDM Family Hx PVD Age 55 yr Hx CVA Male sex TC/HDL-C 6 Microalbuminuria/proteinuria
TG 400 mg/dL TC 250 mg/dL (in lipid-lowering arm)
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
0
50
100
150
200
250
mg/
dl
TC
Baseline 1 Year
LDL-C HDL-C
ASCOT: Lipid Changes with AtorvastatinASCOT: Lipid Changes with Atorvastatin
Sever PS et al. Lancet 2003;361:1149–1158.Reprinted with permission from Elsevier Science.
TG
3 Years
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
0
1
2
3
4
Cum
ulat
ive
Incid
ence
(%)
Years
ASCOT: Primary Endpoint—Nonfatal MI ASCOT: Primary Endpoint—Nonfatal MI and Fatal CHDand Fatal CHD
0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5
Atorvastatin 10 mg Number of events 100Placebo Number of events 154
36%36%reductionreduction
HR = 0.64 (0.50–0.83); p = 0.0005
Sever PS et al. Lancet 2003;361:1149–1158.Reprinted with permission from Elsevier Science.
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
0
1
2
3
Cum
ulat
ive
Incid
ence
(%)
Years
ASCOT: Secondary Endpoint—Fatal MI ASCOT: Secondary Endpoint—Fatal MI and Nonfatal Strokeand Nonfatal Stroke
0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5
Atorvastatin 10 mg Number of events 89Placebo Number of events 121
27%27%reductionreduction
HR = 0.73 (0.56–0.96); p = 0.0236
Sever PS et al. Lancet 2003;361:1149–1158.Reprinted with permission from Elsevier Science.
Slide Source:Lipids Online Slide Librarywww.lipidsonline.org
0
2
4
6
8
10
12
Cum
ulat
ive
Incid
ence
(%)
Years
ASCOT: Secondary Endpoint—All CV ASCOT: Secondary Endpoint—All CV Events and ProceduresEvents and Procedures
0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5
Atorvastatin 10 mg Number of events 389Placebo Number of events 486
21%21%reductionreduction
HR = 0.79 (0.69–0.90); p = 0.0005
Sever PS et al. Lancet 2003;361:1149–1158.Reprinted with permission from Elsevier Science.