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Methods: TNT Study

Prospective, double blind, parallel group trial Completed at 256 sites in 14 countries Between April, 1998, and August, 2004 Median follow-up was 4.9 years Enrolled 10,001 patients aged 35–75 years with clinically evident CAD 5,584 patients had metabolic syndrome

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Methods: TNT Study

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  1. Prospective, double blind, parallel group trial Completed at 256 sites in 14 countries Between April, 1998, and August, 2004 Median follow-up was 4.9 years Enrolled 10,001 patients aged 35–75 years with clinically evident CAD 5,584 patients had metabolic syndrome 2,820 patients were randomly assigned to receive atorvastatin 10 mg per day 2,764 patients were randomly assigned to receive atorvastatin 80 mg per day Primary outcome measure was time to first major cardiovascular event, defined as: – Death from coronary heart disease – Non-fatal non-procedure-related myocardial infarction – Resuscitated cardiac arrest – Fatal or non-fatal stroke Methods: TNT Study Deedwania et al. Lancet 2006;368:919-928.

  2. 0 1 2 3 4 5 6 Patients with Major Cardiovascular Events by Treatment: TNT Study All metabolic syndrome Atorvastatin 10 mg (n=2820)Atorvastatin 80 mg (n=2764) HR (95% Cl)=0.71 (0.61–0.84)p<0.0001 Metabolic syndrome, no diabetes Atorvastatin 10 mg (n=2191)Atorvastatin 80 mg (n=2162) HR (95% Cl)=0.70 (0.557–0.84)p=0.0002 Patients with Major Cardiovascular Event (%) Time to First Major Cardiovascular Event (years) Number at RiskAll Metabolic SyndromeAtv 10 mgAtv 80 mgMetabolic syndrome, no diabetesAtv 10 mgAtv 80 mg 2820276421912162 2728270721292118 2644263520662065 2554256120042018 2464248319451967 124912709941022 0000 Deedwania et al. Lancet 2006; 368:919-928.

  3. 0 1 2 3 4 5 6 Prevalence of Patients with Major Cardiovascular Events in All TNT Patients Metabolic syndrome + diabetes (n=1231) No metabolic syndrome + diabetes (n=270) Metabolic syndrome, no diabetes (n=4353) No metabolic syndrome,no diabetes (n=4147) HR (95%Cl)=2.24(1.87–2.68)*p<0.0001 Patients with Major Cardiovascular Event (%) HR (95%Cl)=1.35 (1.16–1.56) †p<0.0001 Time to First Major Cardiovascular Event (years) * Hazard ratio for patients with metabolic syndrome and diabetes versus patients without metabolic syndrome or diabetes † Hazard ratio for patients with metabolic syndrome without diabetes versus patients without metabolic syndrome or diabetes Deedwania et al. Lancet 2006; 368:919-928.

  4. 0 1 2 3 4 5 Patients with Major Cardiovascular Events by Presence of Metabolic Syndrome Components in All TNT Patients Metabolic Syndrome HR=0.68 (0.48–0.96) Atorvastatin 10 mg Atorvastatin 80 mg HR=0.77 (0.60–1.00) HR=0.69 (0.54–0.89) HR=0.82 (0.57–1.19) HR=0.95 (0.72–1.24) Patients with Major Cardiovascular Events (%) HR=1.35 (0.63–2.90) Number of Metabolic Syndrome Components Deedwania et al. Lancet 2006; 368:919-928.

  5. Support the idea that LDL-C lowering greater than LDL-C lowering achieved with standard doses of statins is warranted in patients with CHD and the metabolic syndrome Also apply to non-diabetic subjects with the metabolic syndrome Results: TNT Study Deedwania et al. Lancet 2006;368:919-928.

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