TNT Trial

To compare the efficacy of 10 mg and 80 mg daily dose of atorvastatin in patients with stable CAD and baseline LDL-C between 130 mg/dL and 250 mg/dL.

The Treating to New Targets (TNT) trial was a randomized trial that enrolled 10,001 patients with stable coronary artery disease to treatment with atorvastatin, 80 or 10 mg/dL, and followed them up for a median period of 4.9 years. The primary end point was a composite of cardiovascular death, myocardial infarction, resuscitated cardiac arrest, and stroke.

Compared to low dose, high dose atorvastatin was associated with:

• A significantly lower mean serum LDL-C concentration (77 vs 101 mg/dL)
• Significant reductions in the rate of the primary end point (8.7 vs 10.9 percent)
• No reduction in all-cause mortality. Higher doses of atorvastatin, although reduced mortality due to cardiac events, were associated with higher mortality rate due to noncardiovascular events.

Wider use of the 80-mg dose of atorvastatin in patients with stable coronary disease is safe, cost-effective, and provides an incremental reduction in coronary events.^[1]