High-dose rosuvastatin induces regression of coronary atherosclerosis, but it remains uncertain whether usual-dose statin has similar effects. We compared the effects of atorvastatin 20 mg/day versus rosuvastatin 10 mg/day on mild coronary atherosclerotic plaques (20% to 50% luminal narrowing and lesion length >10 mm) using intravascular ultrasound (IVUS). Three hundred fifty statin-naive patients with mild coronary atherosclerotic plaques were randomized to receive atorvastatin 20 mg/day or rosuvastatin 10 mg/day. IVUS examinations were performed at baseline and 6-month follow-up. Primary end point was percent change in total atheroma volume (TAV) defined as (TAV at 6 months − TAV at baseline)/(TAV at baseline) × 100. Evaluable IVUS was obtained for 271 patients (atorvastatin in 143, rosuvastatin in 128). Clinical characteristics, lipid levels, and IVUS measurements at baseline were similar between the 2 groups. At 6-month follow-up, percent change in TAV was significantly less in the atorvastatin group than in the rosuvastatin group (−3.9 ± 11.9% vs −7.4 ± 10.6%, respectively, p = 0.018). In contrast, change in percent atheroma volume was not different between the 2 groups (−0.3 ± 4.2 vs −1.1 ± 3.5, respectively, p = 0.157). Compared to baseline, TAV and TAV at the most diseased 10-mm subsegment were significantly decreased in the 2 groups (p <0.001). Changes in lipid profiles at 6-month follow-up were similar between the 2 groups. In conclusion, usual doses of atorvastatin and rosuvastatin induced significant regression of coronary atherosclerosis in statin-naive patients, with a greater decrease in favor of rosuvastatin.
It is no longer uncommon for me to find articles published by Korean investigators
in my specialty, Cardiology, journals, such as this one that appeared in the American
Journal of Cardiology, which is one of reputable journals, though it is not as recognized as
Journal of American College of Cardiology and Circulation.
Nonetheless I feel a pride whenever I find one written by my country men and women.
The topic is appros as well.
Crestor is a brand name statin, known to be somewhat more potent and possibly
somewhat better tolerated by an average patient.
Nonetheless, Crestor and Lipitor are considered to be equal in their efficacy based on
trial results. The findings in this study is not surprising to me, yet important contribution.
A similar study dealing with carotid atherosclerotic plaques in the past suggested a similar trend,
which was statistically of no significance.
Simvastatin failed consistently in a number of mega trials in the past in matching the efficacy
of Lipitor, both in reversing atherosclerosis and side effect profiles.