Is treat-to-target LDL-C strategy noninferior to high-intensity statin therapy for long-term clinical outcomes in patients with coronary artery disease?
Study design: Randomized, multicenter, noninferiority trial
Population
- Number of patients studied: 4400
- Inclusion criteria: Patients with a coronary disease diagnosis treated at 12 centers in South Korea
- Exclusion criteria: Not provided
Interventions
- Experimental group: LDL-C target strategy with a goal of 50 to 70 mg/dL
- Control group: High-intensity statin treatment (rosuvastatin, 20 mg or atorvastatin, 40 mg)
Primary outcome: 3-year composite of death, myocardial infarction, stroke, or coronary revascularization
Secondary outcomes
- All-cause death, MI, stroke
Safety outcomes or Adverse Events
| Safety Outcomes | Treat-to-Target Group (%) | High-Intensity Statin Group (%) | Absolute Difference (%) | 95% CI | P-value |
|---|---|---|---|---|---|
| Composite of new-onset diabetes, aminotransferase or creatine kinase elevation, or end-stage kidney disease | 6.1 | 8.2 | -2.1 | -3.6% to -0.5% | .009 |
Conclusion
In patients with coronary artery disease, a treat-to-target LDL-C strategy with a goal of 50 to 70 mg/dL was noninferior to high-intensity statin therapy for the 3-year composite of death, myocardial infarction, stroke, or coronary revascularization.