ArticleCirculation2006
A tale of two trials: a comparison of the post-acute coronary syndrome lipid-lowering trials A to Z and PROVE IT-TIMI 22.
Article in Circulation, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00251576. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multicenter, Randomized, Controlled, Double-Blind Trial to Investigate the Clinical Efficacy and Tolerability of Early Treatment With Simvastatin 40 mg Daily for 30 Days, Followed by Simvastatin 80 mg Daily Thereafter in Tirofiban-Treated Acute Coronary Syndrome Patients Who Have Been Randomized to Receive Enoxaparin or Unfractionated Heparin in Conjunction With Aspirin
Open the trial in the graphWho cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Effect of statin therapy on the progression of coronary atherosclerosis.BMC cardiovascular disorders · 2012Pooled it
- Intensive statin therapy in acute coronary syndromes and stable coronary heart disease: a comparative meta-analysis of randomised controlled trials.Heart (British Cardiac Society) · 2007Pooled it
- Oral antiplatelet therapy in secondary prevention of cardiovascular events: an assessment from the payer's perspective.PharmacoEconomics · 2007Pooled it
- Effects of Simvastatin on Augmentation Index Are Transient: Outcomes From a Randomized Controlled Trial.Journal of the American Heart Association · 2019Trial
- Association between percutaneous coronary intervention and long-term C-reactive protein levels in patients with acute coronary syndromes.Journal of thrombosis and thrombolysis · 2010Trial
- Therapeutic Management of LDL-C: Efficacy and Economic Impact Assessment.Journal of cardiovascular development and disease · 2025Review
- Hypocholesterolaemic treatment in coronary unit: from statins to anti PCSK9 therapies and bempedoic acid.European heart journal supplements : journal of the European Society of Cardiology · 2023Article
- Challenging Statin Pleiotropy: Preeclampsia.Circulation · 2021Article
- Low-density lipoprotein cholesterol reduction and statin intensity in myocardial infarction patients and major adverse outcomes: a Swedish nationwide cohort study.European heart journal · 2021Article
- Prognostic impact of admission high-sensitivity C-reactive protein in acute myocardial infarction patients with and without diabetes mellitus.Cardiovascular diabetology · 2020Observational
- South Indian Cuisine with Low Glycemic Index Ingredients Reduces Cardiovascular Risk Factors in Subjects with Type 2 Diabetes.International journal of environmental research and public health · 2020Article
- PCSK9 inhibitors: clinical evidence and implementation.Nature reviews. Cardiology · 2019Review
- 'Precision medicine' and ischaemic heart disease: the stage is set for the new antibody based therapies (lipid lowering and anti-inflammatory).European heart journal supplements : journal of the European Society of Cardiology · 2019Article
- Targeting LDL Cholesterol: Beyond Absolute Goals Toward Personalized Risk.Current cardiology reports · 2017Review
- High sensitivity C-reactive protein (hsCRP) & cardiovascular disease: An Indian perspective.The Indian journal of medical research · 2015Review
- Cysteine protease cathepsins and matrix metalloproteinases in the development of abdominal aortic aneurysms.Future cardiology · 2013Review
- Medical angioplasty - hope and expectations: an optimistic overview.Journal of family & community medicine · 2011Article
- 2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult - 2009 recommendations.The Canadian journal of cardiology · 2009Review
- Intensive statin therapy in acute coronary syndromes.Current atherosclerosis reports · 2008Review
- Aggressive statin therapy for acute coronary syndromes.Current cardiology reports · 2007Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Aggrastat to Zocor (A to Z) and Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE IT) trials compared intensive and moderate statin therapy after acute coronary syndromes, 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
resultsStudy 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 death/myocardial infarction. 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 C-reactive protein 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.
conclusionsAn 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 C-reactive protein 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 patients after acute coronary syndrome.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.