RCT | Treat-to-target strategy is noninferior to high-intensity statin therapy in patients with coronary artery disease

Summary: This randomized, multicenter, noninferiority trial in South Korea enrolled 4,400 patients with known coronary artery disease. Patients were randomly assigned to one of two groups: a treat-to-target group and a high-intensity statin group.

The treat-to-target group received moderate or high-intensity statins and titrated their medication to achieve an LDL-C goal of 50-70 mg/dL, while the high-intensity statin group received rosuvastatin 20 mg or atorvastatin 40 mg. The primary endpoint was a 3-year composite of death, myocardial infarction, stroke, or coronary revascularization.

The study found that the primary endpoint occurred in 8.1% of the treat-to-target group and 8.7% of the high-intensity statin group, indicating that the treat-to-target strategy was noninferior to the high-intensity statin strategy.

Overall, the results of this study indicate that a treat-to-target strategy could be an appropriate substitute for high-intensity statin therapy in patients with coronary artery disease. This approach enables a personalized treatment plan that accounts for variations in individual drug response to statin therapy.

Article: Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease: A Randomized Clinical Trial – JAMA (free for a limited period)

Commentaries:

Investigating treat-to-target low-density lipoprotein-cholesterol versus high-intensity statins for coronary artery disease – News Medical

Not all patients with coronary artery disease require high intensity statins – MedicalResearch.com

Commentary on Twitter

Among patients with coronary artery disease, a treat-to-target LDL-C strategy was noninferior to a high-intensity statin strategy for major clinical outcomes. https://t.co/Orv8IeF4Gv #ACC23 #WCCardio pic.twitter.com/NVEEJfQYfJ

— JAMA (@JAMA_current) March 6, 2023