Relation Between Change in Renal Function and Cardiovascular Outcomes in Atorvastatin-Treated Patients (from the Treating to New Targets [TNT] Study)

Statins may have nephroprotective as well as cardioprotective effects in patients with cardiovascular disease. In the Treating to New Targets (TNT) study (NCT00327691), patients with coronary heart disease (CHD) were randomized to atorvastatin 10 or 80 mg/day and followed for 4.9 years. The relation...

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Bibliographic Details
Published in:The American journal of cardiology 2016-04, Vol.117 (8), p.1199-1205
Main Authors: Shepherd, James, MD, Breazna, Andrei, PhD, Deedwania, Prakash C., MD, LaRosa, John C., MD, Wenger, Nanette K., MD, Messig, Michael, PhD, Wilson, Daniel J., MD
Format: Article
Language:English
Subjects:
Adult
Aged
Atorvastatin Calcium - administration & dosage
Body mass index
Cardiovascular
Cardiovascular disease
Cause of Death - trends
Cholesterol
Confidence intervals
Coronary Artery Disease - complications
Coronary Artery Disease - drug therapy
Coronary Artery Disease - mortality
Coronary vessels
Creatinine - blood
Diabetes
Dose-Response Relationship, Drug
Double-Blind Method
Fees & charges
Female
Follow-Up Studies
Glomerular Filtration Rate - drug effects
Glomerular Filtration Rate - physiology
Heart attacks
Heart failure
Heart surgery
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage
Hypertension
Kidney diseases
Kidney Function Tests
Low density lipoprotein
Male
Middle Aged
Mortality
Prospective Studies
Renal Insufficiency, Chronic - etiology
Renal Insufficiency, Chronic - physiopathology
Renal Insufficiency, Chronic - prevention & control
Risk Factors
Rodents
Survival Rate - trends
Triglycerides
United States - epidemiology
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Summary:Statins may have nephroprotective as well as cardioprotective effects in patients with cardiovascular disease. In the Treating to New Targets (TNT) study (NCT00327691), patients with coronary heart disease (CHD) were randomized to atorvastatin 10 or 80 mg/day and followed for 4.9 years. The relation between intrastudy change in estimated glomerular filtration rate (eGFR) from baseline and the risk of major cardiovascular events (MCVEs, defined as CHD death, nonfatal non–procedure-related myocardial infarction, resuscitated cardiac arrest, or fatal or nonfatal stroke) was assessed among 9,500 patients stratified by renal function: improving (change in eGFR more than +2 ml/min/1.73 m2 ), stable (−2 to +2 ml/min/1.73 m2 ), and worsening (less than −2 ml/min/1.73 m2 ). Compared with patients with worsening renal function (1,479 patients, 15.6%), the rate of MCVEs was 28% lower in patients with stable renal function (2,241 patients, 23.6%) (hazard ratio [HR] 0.72; 95% confidence interval [CI] 0.60 to 0.87; p = 0.0005) and 64% lower in patients with improving renal function (5,780 patients, 60.8%; HR 0.36; 95% CI 0.30 to 0.43; p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2016.01.014