Aggressive statin therapy in disease management clinics reduces cardiovascular morbidity for people with coronary heart disease

摘要

Background There is much evidence of the benefits of statins, however, few high quality studies have examined the best way to optimise these benefits in a 'real world' setting. Disease management clinics aim to improve lipid-lowering, but there is limited evidence that these clinics reduce cardiovascular events among people with coronary heart disease.Objective The ALLIANCE study assessed whether an aggressive strategy to lower low-density lipoprotein (LDL) cholesterol in disease management clinics was more successful than usual care for people with coronary heart disease in a 'real world' setting. The primary endpoint was time to first cardiovascular event.Method Sixteen health maintenance organisations and Veterans Affairs clinics in the United States enrolled participants in this randomised controlled trial between July 1995 and June 1998. Average follow up was 51.5 months.