BACKGROUND: The Aggrastat to Zocor (A to Z) and @entity8673 or @entity2993 Evaluation and Infection Therapy (PROVE IT) trials compared intensive and moderate statin therapy after @entity1187 , with seemingly disparate results. We analyzed the design, implementation, and results of the two trials in an attempt to clarify the effects of early intensive statin therapy. METHODS AND RESULTS: Study design, end points, and definitions were compared. In each trial, comparisons were made between intensive and moderate arms for both trials' primary end points and @entity204 / @entity583 . Analyses were performed over various time points: at the end of the trials, < or =4 months, and >4 months. Subjects in A to Z had higher-risk demographics. More PROVE IT subjects were enrolled in the United States and underwent prerandomization revascularization. The low-density lipoprotein (LDL) difference was greater in A to Z than in PROVE IT early (< or =4 months) but less late. Significant @entity1851 reduction was earlier in PROVE IT. With common end points, event rates were higher in A to Z, and early favorable separation of event curves was seen in PROVE IT but not in A to Z. Clinical end point rates and reductions were similar in both trials after 4 months. CONCLUSIONS: An early benefit was seen in PROVE IT but not in A to Z. Late-phase results were similar. Factors that may explain this disparity include the intensity of therapy in the early phase, timing, and magnitude of LDL and @entity1851 lowering, differences in early revascularization, and the play of chance. Taken together, the results of these trials support a strategy of early intensive statin therapy coupled with revascularization when appropriate in @entity1 after @entity1187 .

A tale of two trials: a comparison of the post- XXXX lipid-lowering trials A to Z and PROVE IT-TIMI 22.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['acute coronary syndrome', 'acute coronary syndromes'] @entity2993 :: ('MESH:C065179', 'Chemical') :: ['Atorvastatin'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity8673 :: ('MESH:D017035', 'Chemical') :: ['Pravastatin'] @entity1851 :: ('1401', 'Gene') :: ['C-reactive protein']
@entity1187 :: (MESH:D054058,Disease) :: ['acute coronary syndrome']
