Incremental Decrease in Endpoints through Aggressive Lipid-lowering (IDEAL) trial

Introduction

Prospective, randomized, open-label, blinded end-point evaluation. ,

Study characteristics:

• 8888 patients, with history of myocardial infarction
• < 80 years of age, mean age 62 years, 81% men
• 190 centers in northern Europe 1999-2005.
• study funded by the manufacturer of atorvastatin Treatment
• atorvastatin 80 mg/day vs simvastatin 20 mg/day

Results:

• mean LDL decreases by 49% to 81 mg/dL in atorvastatin group & 33% to 104 mg/dL in simvastatin group
• composite endpoint (sudden death, non-fatal myocardial infarction, cardiac arrest with resuscitation) did not differ betweem groups 9.3% (atorvastatin) vs 10.4% (simvastatin)
• incidence of composite primary endpoint plus stroke lower in atorvastatin group 12% vs 14%.
• adverse effects significantly more common with atorvastatin 9.6% vs 4.2%; discontinuation greater with atorvastatin
• serious myopathy or rhabdomyolysis rare in both groups
• death higher simvastatin group 8.4% vs 8.2%

More general terms

• clinical trial