A recent study published in The BMJ has compared the efficacy and safety of two widely used statins, rosuvastatin and atorvastatin, in individuals with coronary artery disease.
While both statins are effective in preventing heart attacks, strokes, and death, the study found that rosuvastatin was associated with lower cholesterol levels but carried a higher risk of developing type 2 diabetes compared to atorvastatin.
The Importance of Lowering LDL Cholesterol
Lowering “bad” (LDL) cholesterol levels is a common approach recommended for people with coronary artery disease, a condition characterized by narrowed or blocked blood vessels supplying the heart.
Statins are widely prescribed to achieve this goal, but few studies have directly compared the long-term clinical effects of rosuvastatin and atorvastatin in individuals with this condition.
Researchers in Korea conducted the LODESTAR clinical trial, involving 4,400 adults with coronary artery disease.
Participants, with an average age of 65 years and 28% women, were randomly assigned to receive either rosuvastatin or atorvastatin daily for three years (from September 2016 to November 2019).
The study aimed to assess differences between the two groups in terms of various outcomes, including deaths from any cause, heart attacks, strokes, coronary revascularization, and the development of type 2 diabetes, among others.
Key Findings
Comparable Clinical Outcomes: The study found no discernible differences between the two groups for all-cause death, heart attacks, strokes, or any revascularization.
Lower Cholesterol Levels: The average LDL cholesterol level during the study was lower in the rosuvastatin group compared to the atorvastatin group.
Higher Risk of Type 2 Diabetes: Participants in the rosuvastatin group had a higher rate of developing type 2 diabetes requiring medication compared to those in the atorvastatin group.
Cataract Surgery Risk: The rosuvastatin group also had a higher risk of undergoing cataract surgery.
Other Safety Outcomes: Apart from the above differences, other safety outcomes did not significantly differ between the two groups.
The study had limitations, including the inclusion of only Asian participants and a relatively short three-year study period. Longer-term effects of the two statin types may not have been fully captured in this timeframe.
In individuals with coronary artery disease, rosuvastatin and atorvastatin demonstrated comparable effectiveness in preventing a composite of all-cause death, myocardial infarction, stroke, or any coronary revascularization within three years.
Notably, rosuvastatin led to lower LDL cholesterol levels but was associated with a higher risk of new-onset diabetes requiring antidiabetic medication and cataract surgery compared to atorvastatin.
While these findings are informative, the researchers recommend cautious interpretation and suggest the need for further investigation with longer follow-up periods to fully understand the implications of these statins in the management of coronary artery disease.
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The research findings can be found in The BMJ.
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