Author + information
- Michael Szarek,
- Pierre Amarenco,
- Alfred Callahan,
- David DeMicco,
- Rana Fayyad,
- Larry Goldstein,
- Rachel Laskey,
- Henrik Sillesen and
- K. Michael Welch
In SPARCL, first vascular event was reduced from 687 for placebo to 530 for atorvastatin (hazard ratio [HR] 0.74; p<0.001), with significant reductions in stroke or TIA, coronary events, and revascularization procedures. Here we describe treatment effects on total (first and subsequent) vascular events to quantify the totality of atorvastatin efficacy after recent stroke or TIA.
4731 patients with stroke or TIA 1-6 months before study entry, LDL-C 100 - 190 mg/dL, and no known CHD were randomized 1:1 to atorvastatin 80mg or placebo. Treatment effects on total adjudicated vascular events (vascular death; nonfatal stroke; nonfatal MI; unstable angina; hospitalized angina or ischemia; resuscitation after cardiac arrest; coronary, carotid, or peripheral revascularization; clinically significant PVD), overall and by vascular bed (cerebrovascular, coronary, or peripheral), are summarized by mean cumulative function rates and HRs from marginal proportional hazards models.
There were 390 fewer total vascular events with atorvastatin (HR 0.68; p<0.001), including 177 fewer cerebrovascular, 170 fewer coronary, and 43 fewer peripheral events (figure). Over 6 years, 20 vascular events per 100 patients were avoided with atorvastatin treatment.
Atorvastatin prevented more than twice the number of total events than first events, with reductions in all vascular beds. Total event reduction is a useful metric to gauge atorvastatin efficacy after recent stroke or TIA.
Moderated Poster Contributions
Valvular Heart Disease and Vascular Medicine Moderated Poster Theater, Posters, Hall A
Saturday, March 28, 2020, 1:00 p.m.-1:10 p.m.
Session Title: On the Cutting Edge in Peripheral Artery Disease
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1019-07
- 2020 American College of Cardiology Foundation