Effects of statin treatment in men and women with stable coronary heart disease: a subgroup analysis of the GREACE Study.

Abstract:

BACKGROUND:Reducing low-density lipoprotein cholesterol (LDL-C) levels to National Cholesterol Expert Panel (NCEP) goal is recommended. However, sex-specific effects may influence benefit. METHODS AND RESULTS:In this post hoc analysis of the GREek Atorvastatin and Coronary heart disease (CHD) Evaluation [GREACE] study we investigated the extent in vascular event reduction by statin treatment according to sex. From a total of 1600 patients with stable CHD, 624/176 and 632/168 were men/women on atorvastatin or on usual care, respectively. During 3-year follow-up, comparison of atorvastatin treatment with usual care demonstrated a relative risk reduction (RRR) of the primary end point (all vascular events) of 54% in women (hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.24-0.87, p=0.003) and of 50% in men (HR 0.50, 95% CI 0.32-0.70, p<0.001). The fall in LDL-C levels played the key role in end point reduction in both sexes. However, in men there was an additional benefit related to the atorvastatin-induced increase in high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR), while in women end points were related to a substantial triglycerides (TG) reduction. CONCLUSIONS:Treatment with atorvastatin to the NCEP LDL-C goal compared with 'usual care' significantly reduced CHD morbidity and mortality in both men and women. Both men and women benefited from statin treatment possibly with different mechanisms making a contribution over and above LDL-C reduction.

journal_name

Curr Med Res Opin

authors

Athyros VG,Kakafika AI,Papageorgiou AA,Paraskevas KI,Tziomalos K,Anagnostis P,Pagourelias E,Koumaras C,Karagiannis A,Mikhailidis DP

doi

10.1185/03007990802069563

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

1593-9

issue

6

eissn

0300-7995

issn

1473-4877

pii

4490

journal_volume

24

pub_type

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