Table 3.
Effect of atorvastatin on CVD events by level of CRP or LDL-cholesterol achieved at 1 year
| CVD event (N = 2,258) | Events/persons (event rate/100 person-years) |
Model 0a, adjusted HR (95% CI) |
Model 1b, adjusted HR (95% CI) |
Model 2c, adjusted HR (95% CI) |
|---|---|---|---|---|
| Major cardiovascular event (116 cases) | ||||
| Placebo (74 cases) | 74/1,115 (2.33) | 1 | 1 | 1 |
| Atorvastatin (42 cases) | ||||
| LDL-c <2 mmol/l [77 mg/dl] | 28/719 (1.32) | 0.54 (0.35, 0.83) | 0.58 (0.37, 0.89) | 0.58 (0.37, 0.90) |
| LDL-c ≥2 mmol/l [77 mg/dl] | 14/424 (1.18) | 0.58 (0.33, 1.03) | 0.51 (0.28, 0.92) | 0.51 (0.28, 0.91) |
| CRP <19.0 nmol/l [2 mg/l] | 30/752 (1.35) | 0.55 (0.36, 0.83) | 0.53 (0.35, 0.82) | 0.55 (0.36, 0.84) |
| CRP ≥19.0 nmol/l [2 mg/l] | 12/391 (1.12) | 0.57 (0.31, 1.06) | 0.59 (0.32, 1.09) | 0.54 (0.29, 1.01) |
| CRP fell by year 1 | 22/624 (1.22) | 0.53 (0.33, 0.85) | 0.54 (0.33, 0.86) | 0.54 (0.34, 0.88) |
| CRP did not fall | 20/519 (1.34) | 0.58 (0.35, 0.95) | 0.56 (0.34, 0.93) | 0.55 (0.33, 0.91) |
| LDL-c <1.8 mmol/l [70 mg/dl] | 19/577 (1.10) | 0.45 (0.27, 0.74) | 0.48 (0.29, 0.80) | 0.48 (0.29, 0.81) |
| LDL-c ≥1.8 mmol/l [70 mg/dl] | 23/566 (1.46) | 0.69 (0.43, 1.10) | 0.63 (0.39, 1.03) | 0.63 (0.39, 1.02) |
| CRP <9.5 nmol/l [1 mg/l] | 20/500 (1.30) | 0.50 (0.30, 0.82) | 0.49 (0.30, 0.80) | 0.51 (0.31, 0.84) |
| CRP ≥9.5 nmol/l [1 mg/l] | 22/643 (1.24) | 0.61 (0.38, 0.99) | 0.62 (0.38, 1.00) | 0.58 (0.36, 0.94) |
| % Change in LDL-c < mediand | 21/588 (1.19) | 0.50 (0.31, 0.81) | 0.50 (0.30, 0.80) | 0.50 (0.31, 0.82) |
| % Change in LDL-c ≥ median | 21/555 (1.37) | 0.62 (0.38, 1.01) | 0.62 (0.38, 1.01) | 0.61 (0.37, 1.00) |
| % Change in CRP < mediane | 20/571 (1.20) | 0.51 (0.31, 0.84) | 0.52 (0.32, 0.85) | 0.52 (0.32, 0.86) |
| % Change in CRP ≥ median | 22/572 (1.35) | 0.60 (0.37, 0.96) | 0.58 (0.36, 0.94) | 0.57 (0.35, 0.92) |
| Any cardiovascular event (190 cases) | ||||
| Placebo (116 cases) | 116/1,115 (3.73) | 1 | 1 | |
| Atorvastatin (74 cases) | ||||
| LDL-c <2 mmol/l [77 mg/dl] | 44/719 (2.10) | 0.55 (0.39, 0.78) | 0.58 (0.41, 0.83) | 0.59 (0.41, 0.84) |
| LDL-c ≥2 mmol/l [77 mg/dl] | 30/424 (2.59) | 0.76 (0.50, 1.14) | 0.67 (0.44, 1.03) | 0.67 (0.44, 1.02) |
| CRP <19.0 nmol/l [2 mg/l] | 52/752 (2.37) | 0.61 (0.44, 0.85) | 0.62 (0.45, 0.86) | 0.64 (0.46, 0.89) |
| CRP ≥19.0 nmol/l [2 mg/l] | 22/391 (2.08) | 0.62 (0.39, 0.99) | 0.62 (0.39, 0.99) | 0.58 (0.36, 0.93) |
| CRP fell by year 1 | 44/624 (2.49) | 0.68 (0.48, 0.96) | 0.67 (0.48, 0.96) | 0.67 (0.47, 0.95) |
| CRP did not fall | 30/519 (2.03) | 0.54 (0.36, 0.82) | 0.55 (0.37, 0.83) | 0.56 (0.37, 0.84) |
| LDL-c <1.8 mmol/l [70 mg/dl] | 31/577 (1.81) | 0.47 (0.32, 0.70) | 0.50 (0.33, 0.75) | 0.51 (0.34, 0.77) |
| LDL-c ≥1.8 mmol/l [70 mg/dl] | 43/566 (2.80) | 0.80 (0.56, 1.14) | 0.74 (0.51, 1.06) | 0.73 (0.51, 1.06) |
| CRP <9.5 nmol/l [1 mg/l] | 37/500 (2.46) | 0.61 (0.42, 0.89) | 0.62 (0.43, 0.90) | 0.65 (0.45, 0.95) |
| CRP ≥9.5 nmol/l [1 mg/l] | 37/643 (2.12) | 0.62 (0.43, 0.90) | 0.62 (0.43, 0.90) | 0.59 (0.40, 0.86) |
| % Change in LDL-c < mediand | 38/588 (2.19) | 0.58 (0.40, 0.84) | 0.57 (0.40, 0.83) | 0.59 (0.41, 0.85) |
| % Change in LDL-c ≥ median | 36/555 (2.38) | 0.66 (0.45, 0.97) | 0.67 (0.46, 0.97) | 0.65 (0.45, 0.96) |
| % Change in CRP < mediane | 42/571 (2.58) | 0.69 (0.48, 0.98) | 0.69 (0.48, 0.98) | 0.68 (0.48, 0.97) |
| % Change in CRP ≥ median | 32/572 (1.98) | 0.54 (0.36, 0.80) | 0.55 (0.37, 0.82) | 0.53 (0.37, 0.83) |
aModel 0, age and sex
bModel 1, model 0 + baseline LDL-cholesterol or CRP
cModel 2, model 1 + race, smoking status, systolic blood pressure, BMI and HbA1c
dThe median (IQR) achieved LDL-cholesterol level was 3.12 (2.58, 3.64) mmol/l [121 (100, 141) mg/dl] in the placebo arm and 1.79 (1.41, 2.23) mmol/l [60 (65, 86) mg/dl] in the atorvastatin arm
eThe median (IQR) achieved CRP level was 17.2 (8.0, 39.1) nmol/l [1.81 (0.84, 4.12) mg/l] in the placebo arm and 11.8 (5.0, 27.2) nmol/l [1.24 (0.53, 2.86) mg/l] in the atorvastatin arm
LDL-c, LDL-cholesterol