TY - JOUR T1 - Effect of intensive statin therapy on clinical outcomes among patients undergoing percutaneous coronary intervention for acute coronary syndrome. PCI-PROVE IT: A PROVE IT-TIMI 22 (Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction 22) Substudy. AU - Gibson,C Michael, AU - Pride,Yuri B, AU - Hochberg,Claudia P, AU - Sloan,Sarah, AU - Sabatine,Marc S, AU - Cannon,Christopher P, AU - ,, PY - 2009/04/10/received PY - 2009/09/01/revised PY - 2009/09/14/accepted PY - 2009/12/5/entrez PY - 2009/12/5/pubmed PY - 2010/1/6/medline SP - 2290 EP - 5 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 54 IS - 24 N2 - OBJECTIVES: The goal of this analysis was to determine whether intensive statin therapy, compared with moderate-dose statin therapy, leads to a reduction in major adverse cardiovascular events (MACE) among patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). BACKGROUND: When compared with moderate-dose statins, intensive statin therapy reduces MACE among patients with ACS. The role of intensive statin therapy specifically among patients who undergo PCI for ACS is unknown. METHODS: Outcomes were compared in 2,868 patients who underwent PCI for ACS just prior to enrollment in the PROVE IT-TIMI 22 (Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction 22) trial, which randomized patients to either atorvastatin 80 mg or pravastatin 40 mg daily. The incidence of the primary composite end point of all-cause mortality, myocardial infarction, unstable angina leading to hospitalization, and revascularization after 30 days and stroke was evaluated, as was the incidence of target vessel revascularization (TVR) and non-TVR during follow-up. RESULTS: Treatment with 80 mg atorvastatin reduced the incidence of the composite end point (21.5% vs. 26.5%, hazard ratio: 0.78, 95% confidence interval: 0.67 to 0.91, p=0.002) and lowered the incidence of both TVR (11.4% vs. 15.4%, p=0.001) and non-TVR (8.0% vs. 10.5%, p=0.017) compared with 40 mg pravastatin. After adjusting for on-treatment serum low-density lipoprotein cholesterol and C-reactive protein concentrations, the odds of TVR with high-dose statin therapy remained significant (odds ratio: 0.74, p=0.015) while the odds of non-TVR did not (odds ratio: 0.92, p=0.55). CONCLUSIONS: Among patients with ACS who undergo PCI, intensive statin therapy reduces MACE compared with moderate-dose statin therapy. The reduction in the incidence of TVR was independent of low-density lipoprotein cholesterol and C-reactive protein lowering and may therefore be due, at least in part, to a pleiotropic effect of high-dose statin therapy. (PROVE IT-TIMI 22; NCT00382460). SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/19958964/Effect_of_intensive_statin_therapy_on_clinical_outcomes_among_patients_undergoing_percutaneous_coronary_intervention_for_acute_coronary_syndrome__PCI_PROVE_IT:_A_PROVE_IT_TIMI_22__Pravastatin_or_Atorvastatin_Evaluation_and_Infection_Therapy_Thrombolysis_In_Myocardial_Infarction_22__Substudy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(09)03086-1 DB - PRIME DP - Unbound Medicine ER -