title: Effect of intensive lipid-lowering therapy on cardiovascular outcome in patients with and those without inflammatory joint disease.
abstract: OBJECTIVE
  To examine the effect of intensive lipid-lowering therapy on a composite cardiovascular outcome (cardiovascular disease [CVD]), consisting of mortality and morbidity end points, in patients with inflammatory joint disease (rheumatoid arthritis [RA], ankylosing spondylitis [AS], or psoriatic arthritis [PsA]) by post hoc analysis of 2 prospective trials of statins with a secondary end point of CVD outcome (the Treating to New Targets [TNT] and Incremental Decrease in End Points Through Aggressive Lipid Lowering [IDEAL] studies).
  
  
  METHODS
  Of the 18,889 patients participating in the 2 trials, 199 had RA, 46 had AS, and 35 had PsA. Lipid-lowering therapy consisted of an intensive regimen of atorvastatin 80 mg or a conventional/low-dose regimen of atorvastatin 10 mg or simvastatin 20-40 mg. The median duration of followup was nearly 5 years. Changes in lipid levels were examined by analyses of covariance. The effect on CVD was examined by Cox regression analyses, and heterogeneity tests were performed.
  
  
  RESULTS
  Patients with RA and those with AS had lower baseline cholesterol levels than patients without inflammatory joint disease (least squares mean ± SEM 180.7 ± 2.3 mg/dl and 176.5 ± 4.7 mg/dl, respectively, versus 185.6 ± 0.2 mg/dl; P = 0.03 and P = 0.05, respectively). Statin treatment led to a comparable decrease in lipid levels and a 20% reduction in overall risk of CVD in both patients with and those without inflammatory joint disease.
  
  
  CONCLUSIONS
  Our findings indicate that patients with and those without inflammatory joint disease experience comparable lipid-lowering effects and CVD risk reduction after intensive treatment with statins.
authors.affiliation: Diakonhjemmet Hospital, Oslo, Norway. anne.semb@yahoo.no
authors.forename: Anne Grete
authors.initials: AG
authors.lastname: Semb
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.forename: David A
authors.initials: DA
authors.lastname: DeMicco
authors.forename: Rana
authors.initials: R
authors.lastname: Fayyad
authors.forename: Chuan-Chuan
authors.initials: CC
authors.lastname: Wun
authors.forename: John C
authors.initials: JC
authors.lastname: LaRosa
authors.forename: John
authors.initials: J
authors.lastname: Betteridge
authors.forename: Terje R
authors.initials: TR
authors.lastname: Pedersen
authors.forename: Ingar
authors.initials: I
authors.lastname: Holme
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001168:Arthritis / Q000150:complications*; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000627:therapeutic use*; D019821:Simvastatin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin