Source: DGNews  |  Posted 2 years ago

By Bruce Sylvester

ORLANDO, Fla -- November 18, 2009 -- Intensive treatment of dyslipidaemia with atorvastatin 80 mg daily in patients with coronary heart disease (CHD) and the metabolic syndrome appears to reverse or reduce the progression of chronic kidney disease, according to a study presented here at the American Heart Association (AHA) Scientific Sessions 2009.

“The TNT [Treating to New Targets] study confirms prior reports of a significant association between the metabolic syndrome and chronic kidney disease, and extends this observation to a population with stable coronary heart disease,” said lead investigator Prakash Deedwania, MD, University of California, San Francisco School of Medicine, Fresno, California, during a poster presentation on November 15.

Following 8 weeks of open-label therapy with atorvastatin 10 mg, researchers randomised 10,001 patients with CHD to double-blind therapy with either atorvastatin 10 or 80 mg. Patients were followed for a median of 4.9 years and were evaluated for occurrence of the primary endpoint; CHD death, nonfatal myocardial infarction (MI), and stroke.

They also assessed change in estimated glomerular filtration rate (eGFR) from baseline to last visit prior to primary endpoint according to metabolic syndrome status.

They determined the metabolic syndrome was present in patients with 3 or more of the following: body mass index >=28 kg/m²; triglycerides >150 mg/dL; high-density lipoprotein cholesterol <40 mg/dL (men), <50 mg/dL (women); blood pressure >=130/85 mm Hg; and fasting glucose >=100 mg/dL.

A total of 9,500 patients (5,287 with the metabolic syndrome and 4,213 without) with a follow-up eGFR were included in the current sub-analysis.

Mean baseline eGFR was 64.4 mL/min/1.73 m² in patients with the metabolic syndrome and 66.5 mL/min/1.73 m² in patients without.

Overall, patients without the metabolic syndrome achieved significantly greater improvement in eGFR that patients with the metabolic syndrome (P < .0001).

Mean change from baseline eGFR was significantly greater in patients receiving atorvastatin 80 mg than atorvastatin 10 mg, regardless of metabolic syndrome status (P < .0001).

“In patients with stable chronic heart disease, more intensive therapy with atorvastatin 80 mg resulted in greater renal benefit on improvement of renal function, irrespective of metabolic syndrome or chronic kidney disease status at baseline,” concluded Dr. Deedwania.

Funding for this study was provided by Pfizer Inc.

Presentation title: Improvement in Estimated Glomerular Filtration Rate With Atorvastatin in Patients With Metabolic Syndrome: The Treating to New Targets Study. Abstract 848