SAGE Trial.pptVIP

SAGE Trial SAGE Trial: Background Atherosclerosis is a progressive disease and therefore coronary artery disease (CAD) is most prevalent in older persons. The risk of CAD events can reduced by lowering low-density lipoprotein cholesterol (LDL-C), for which statins are the preferred drug. However, no studies to date have assessed intensive versus moderate statin therapy in older patients with stable coronary syndromes. SAGE Trial: Background The purpose of the SAGE study was to compare the effects of intensive versus moderate statin therapy on the reduction of myocardial ischemia, as assessed by ambulatory ECG, in older men and women with stable CAD. SAGE Trial: Baseline Characteristics SAGE Trial: Primary Efficacy Endpoint SAGE Trial: Secondary Efficacy and Lipid Parameters There were no significant differences between atorvastatin and pravastatin for any of the secondary efficacy parameters at month 3 or month 12. Compared with pravastatin 40 mg/d, atorvastatin 80 mg/d produced significantly greater decreases in total cholesterol, LDL-C, triglycerides, and apolipoprotein B at month 3 and at month 12 (all P0.001). Levels of HDL-C increased in both groups, with significantly larger increases in the pravastatin group at month 3 (p0.001) and 12 (p=0.009) than in the atorvastatin group. SAGE Trial: Lipid Parameters SAGE Trial: Lipid Parameters SAGE Trial: MACE and All-Cause Mortality SAGE Trial: Limitations It is possible that reductions in ischemia did not differ significantly between the 2 treatment groups because ambulatory ischemia is not an adequately sensitive measure of change in cardiovascular event risk. The study may have been underpowered to detect differences between the 2 treatment groups. The number of events for the mortality analysis was small and was analyzed post-hoc. SAGE Trial: Summary After comparing the effects of intensive versus moderate statin therapy in older individuals, this study found that both regimens were equally effective in th