- ALLHAT-LLT研究
- 幻灯语言：英文
- 幻灯大小：60KB
- 幻灯类型：PPT
- 发布时间：2007-11-21 8:10:57
- 应用平台：Win9x/Me/NT/2000/XP
- 相关网站：internet
-
- 版权说明：本站所有资源来源于网络，版权为原作者所有，本站刊载，仅限于促进医药行业发展、科技进步之目的。如本站行为侵犯了您的合法权益，请来信
告知，我们将妥善处理。给您带来不便，敬请原谅。 - 幻灯介绍：
Lipid Lowering Substudy Trial of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
JAMA 2002;288:2998-3007
ALLHAT- LLT
10,355 patients with moderate hypercholesterolemia
All patients enrolled in the ALLHAT antihypertensive trial
Fasting LDL-C level of 120-189 mg/dL with no known CHD or 100-129 mg/dL with known CHD
Fasting triglyceride levels <350 mg/dL
NHLBI funded trial
Endpoints:
Primary – All-cause mortality Fatal coronary heart disease and nonfatal MI
Secondary – Fatal coronary heart disease and nonfatal MI, stroke, CHF, cancer
Mean follow-up 4.8 years
ALLHAT- LLT
JAMA 2002;288:2998-3007
Pravastatin
40 mg/day
(n=5,170)
Usual Care
at discretion of primary care physician
(n=5,185)
All Cause Mortality
RR = 0.99
p = 0.88
ALLHAT- LLT: Clinical Endpoints
Pravastatin
Usual Care
Fatal Heart Disease
or Nonfatal MI
RR = 0.91
p = 0.16
Stroke
RR = 0.91
p = 0.31
JAMA 2002;288:2998-3007
Pravastatin
Usual Care
Pravastatin
Usual Care
Pravastatin
? 17.2%
ALLHAT- LLT: Total Cholesterol
Baseline
4 Year Follow-up
Usual Care
? 7.6%
mg/dL
Baseline
4 Year Follow-up
JAMA 2002;288:2998-3007
mg/dL
Pravastatin
? 27.7%
ALLHAT- LLT: LDL Cholesterol
Baseline
4 Year Follow-up
Usual Care
? 11.0%
mg/dL
Baseline
4 Year Follow-up
JAMA 2002;288:2998-3007
mg/dL
ALLHAT- LLT: Summary
Despite moderate reduction in cholesterol with pravastatin, there was no difference in mortality, CHD or stroke compared with usual care for moderate hypercholesterolemiaHigh crossover rate from usual care to statin treatment (8% at year 2 and 17% at year 4) may explain the only moderate difference in cholesterol reduction and the lack of clinical benefit between the two arms
A greater benefit was observed in blacks than in nonblacks with pravastatin for fatal heart disease or nonfatal MI endpoint (RR 0.73 vs 1.02, p=0.03)
Lack of clinical benefit with statin therapy contrasts with other large statin trials (4S, CARE, LIPID, and PROSPER)
Meta-analysis of 9 large statin trials including ALLHAT-LLT shows CHD events ? 27% and mortality ? 14% with statin therapy
