Titre du document / Document title

Analysis of efficacy and safety in patients aged 65-75 years at randomization : Collaborative Atorvastatin Diabetes Study (CARDS)

Auteur(s) / Author(s)

The Cards Study Investigators
NEIL H. Andrew W. ⁽¹⁾ ; DEMICCO David A. ⁽²⁾ ; LUO Don ⁽²⁾ ; BETTERIDGE D. John ⁽³⁾ ; COLHOUN Helen M. ⁽⁴⁾ ; DURRINGTON Paul N. ⁽⁵⁾ ; LIVINGSTONE Shonaj. ⁽⁶⁾ ; FULLER John H. ⁽⁶⁾ ; HITMAN Graham A. ⁽⁷⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, ROYAUME-UNI
⁽²⁾ Pfizer, New York, New York, ETATS-UNIS
⁽³⁾ The Middlesex Hospital, University College London, London, ROYAUME-UNI
⁽⁴⁾ The Conway Institute, University College Dublin, Dublin, IRLANDE
⁽⁵⁾ Department of Medicine, Manchester Royal Infirmary, University of Manchester, Manchester, ROYAUME-UNI
⁽⁶⁾ Department of Epidemiology and Public Health, Royal Free and University College Medical School, London, ROYAUME-UNI
⁽⁷⁾ Centre for Diabetes and Metabolic Medicine, Barts and The London Queen Mary's School of Medicine and Dentistry, London, ROYAUME-UNI

Résumé / Abstract

OBJECTIVE - Rates of cardiovascular disease are highest in the elderly. Lipid-lowering statin therapy reduces the proportional risk as effectively in older patients as in younger individuals; however, limited data are available for elderly patients with type 2 diabetes. We conducted a post hoc analysis to compare the efficacy and safety of atorvastatin among 1,129 patients aged 65-75 years at randomization with 1,709 younger patients in the Collaborative Atorvastatin Diabetes Study (CARDS). RESEARCH DESIGN AND METHODS - CARDS was a randomized placebo-controlled trial of 10 mg/day atorvastatin for primary prevention of cardiovascular disease in patients aged 40-75 years with LDL cholesterol concentrations ≤4.14 mmol/l followed for a median of 3.9 years. The primary end point was time to first occurrence of acute coronary heart disease events, coronary revascularizations, or stroke. RESULTS ¯ Atorvastatin treatment resulted in a 38% reduction in relative risk ([95% CI -58 to -8], P = 0.017) of first major cardiovascular events in older patients and a 37% reduction ([-57 to - 7], P= 0.019) in younger patients. Corresponding absolute risk reductions were 3.9 and 2.7%, respectively (difference 1.2% [95% CI -2.8 to 5.3], P = 0.546); numbers needed to treat for 4 years to avoid one event were 21 and 33, respectively. All-cause mortality was reduced nonsignificantlyby 22% ([-49 to 18], P = 0.245) and 37% ([-64 to 9], P = 0.98), respectively. The overall safety profile of atorvastatin was similar between age-groups. CONCLUSIONS- Absolute and relative benefits of statin therapy in older patients with type 2 diabetes are substantial, and all patients warrant treatment unless specifically contraindicated.

Revue / Journal Title

Diabetes care   ISSN 0149-5992   CODEN DICAD2 

Source / Source

2006, vol. 29, n^o11, pp. 2378-2384 [7 page(s) (article)] (19 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Diabetes Association, Alexandria, VA, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Metabolic diseases ; Dyslipemia ; Endocrinopathy ; Statin derivative ; Enzyme inhibitor ; Enzyme ; Oxidoreductases ; Hydroxymethylglutaryl-CoA reductase ; Lipids ; Type 2 diabetes ; Elderly ; Hyperlipemia ; Randomization ; Age ; Human ; Treatment efficiency ; Atorvastatin ;

Mots-clés français / French Keywords

Inhibiteur de l'HMG-CoA reductase ; Métabolisme pathologie ; Dyslipémie ; Endocrinopathie ; Statine dérivé ; Inhibiteur enzyme ; Enzyme ; Oxidoreductases ; Hydroxymethylglutaryl-CoA reductase ; Lipide ; Diabète type 2 ; Personne âgée ; Hyperlipémie ; Randomisation ; Age ; Homme ; Efficacité traitement ; Atorvastatine ;

Mots-clés espagnols / Spanish Keywords

Metabolismo patología ; Dislipemia ; Endocrinopatía ; Statina derivado ; Inhibidor enzima ; Enzima ; Oxidoreductases ; Hydroxymethylglutaryl-CoA reductase ; Lípido ; Diabetes de tipo 2 ; Anciano ; Hiperlipemia ; Aleatorización ; Edad ; Hombre ; Eficacia tratamiento ; Atorvastatina ;

Localisation / Location

INIST-CNRS, Cote INIST : 18054, 35400015887103.0070