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首页> 外文期刊>The American Journal of Cardiology >Comparison of efficacy and safety of atorvastatin (80 mg) to simvastatin (20 to 40 mg) in patients aged <65 versus >or=65 years with coronary heart disease (from the Incremental DEcrease through Aggressive Lipid Lowering (IDEAL) study).
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Comparison of efficacy and safety of atorvastatin (80 mg) to simvastatin (20 to 40 mg) in patients aged <65 versus >or=65 years with coronary heart disease (from the Incremental DEcrease through Aggressive Lipid Lowering (IDEAL) study).

机译：在65岁以下或≥65岁的冠心病患者中，阿托伐他汀（80毫克）与辛伐他汀（20至40毫克）的疗效和安全性比较（来自通过积极降脂（IDEAL）进行的增量减少）。

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摘要

The efficacy and safety of atorvastatin (80 mg/day) versus simvastatin (20 to 40 mg/day) in older (age >or=65 years) versus younger (<65 years) patients were assessed in a prespecified secondary analysis of the 8,888 patients with myocardial infarction in the IDEAL trial, a randomized open-label study. Several cardiovascular end points were evaluated, including the occurrence of a first major coronary event (MCE; nonfatal myocardial infarction, coronary heart disease death, or resuscitated cardiac arrest), the primary end point of the trial, and occurrence of any cardiovascular event (MCE, stroke, revascularization, unstable angina, congestive heart failure, and peripheral artery disease). Although there were no significant interactions between age and treatment, the magnitude of effect in favor of atorvastatin was higher in younger versus older patients (occurrence of first MCE, hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.66 to 0.98; and HR 0.95, 95% CI 0.80 to 1.15, respectively; occurrence of any cardiovascular (CV) event, HR 0.80, 95% CI 0.71 to 0.89; and HR 0.88, 95% CI 0.79 to 0.99, respectively). These results were likely influenced by adherence, which was lower in older patients and those receiving atorvastatin compared with those receiving simvastatin. Rates of any reported serious adverse event were higher in older patients, but did not differ between the 2 statin groups. In conclusion, except for any CV events in the older group, significant reductions in primary and secondary end points were observed only in patients <65 years of age. The safety of atorvastatin (80 mg) and simvastatin (20 to 40 mg) was similar in patients aged <65 and >65 years with stable coronary disease.
机译：在对8,888名患者的预先确定的二级分析中评估了阿托伐他汀（80毫克/天）与辛伐他汀（20至40毫克/天）在年龄较大（≥65岁）与年轻（<65岁）患者中的疗效和安全性。 IDEAL试验中的心肌梗死患者是一项随机开放标签研究。评估了几个心血管终点，包括首次重大冠状动脉事件（MCE;非致命性心肌梗塞，冠心病死亡或复苏的心脏骤停）的发生，试验的主要终点以及任何心血管事件（MCE）的发生，中风，血运重建，不稳定型心绞痛，充血性心力衰竭和周围动脉疾病）。尽管年龄和治疗之间没有显着的相互作用，但年轻患者与老年患者相比，阿托伐他汀的疗效更高（首次发生MCE，危险比[HR] 0.80，95％置信区间[CI] 0.66至0.98;和HR 0.95，95％CI 0.80至1.15;发生任何心血管（CV）事件，HR 0.80，95％CI 0.71至0.89; HR 0.88，95％CI 0.79至0.99）。这些结果可能受依从性的影响，老年患者和接受阿托伐他汀的患者比接受辛伐他汀的患者低。在老年患者中，任何报告的严重不良事件的发生率均较高，但两组他汀类药物之间无差异。总之，除老年组中的任何心血管事件外，仅在<65岁的患者中观察到主要终点和次要终点的显着降低。阿托伐他汀（80 mg）和辛伐他汀（20至40 mg）的安全性在年龄<65岁和> 65岁的稳定冠心病患者中相似。

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