atorvastatin vs rosuvastatin in acs

In order to compare the effects of atorvastatin and rosuvastatin on the inflammatory markers in patients of ACS, we included adult patients of age 18 years and above, of both genders, diagnosed with STEMI, NSTEMI, or UA according to World Health Organization criteria [12] who were not taking statins. We correlated the means within each group (baseline vs. four weeks) by applying dependent T-test and within the two groups (at four weeks of group A vs. group B) by applying independent T-test. "Never doubt that a small group of thoughtful, committed citizens can change the world. doi:10.7759/cureus.4898. The changes in hs-CRP levels in both groups during the study period is shown below in Table 1. Hs-CRP has been established to play a critical role in all steps of atherogenesis such as complement activation, activity of macrophages, inflammatory cytokine release, tissue factor induction, endothelial dysfunction, and production of nitric oxide [4]. Further concerns about rosuvastatin’s renal effects were seen in an AstraZeneca funded randomized study comparing high dose rosuvastatin with atorvastatin in diabetic patients with progressive kidney disease.19 Although rosuvastatin lowered plasma lipid concentrations to a greater extent than atorvastatin, the study reported that “atorvastatin seems to have more renoprotective effects.” Urinary protein excretion was reduced during one year of treatment with atorvastatin … Files available from the ACS website may be downloaded for personal use only. Indeed, it is the only thing that ever has.". Learn more here. Serum lipid profile, hs-CRP, and ESR were recorded for all patients at baseline (before starting therapy) and then again after four weeks. Only the R10 group had a decrease in macrophage density (-23%, p = 0.04) and microvessels (-12%, p = 0.002). Rosuvastatin was more effective in reducing hs-CRP levels than atorvastatin [17]. Epub 2012 Mar 20. While all registered Cureus users can rate any published article, the opinion of domain experts is weighted appreciably more than that of non-specialists. Khurana et al. The case with ESR is similar. The mean change in lipid profile in both groups during the study period is shown below in Table 3. Elevated hs-CRP has been established as a prognostic indicator of new MACE and mortality in patients with ACS [19]. Privacy Policy doi:10.7759/cureus.4898, Received by Cureus: May 24, 2019 In the LUNAR (Limiting UNdertreatment of lipids in ACS with Rosuvastatin) study, the finding suggests that rosuvastatin 40 mg/day was significantly more effective than atorvastatin 80 mg/day in decreasing LDL-C and other important lipid parameters, such as apolipoprotein AI, LDL-C/HDL-C, non-HDL-C/HDL-C, TC/HDL-C, and apolipoprotein B/apolipoprotein AI, is consistent with previous … We aimed to investigate coronary plaque response to treatment with different statins that result in similar lipid reduction using serial multimodality intracoronary imaging. Systematic study of the effects of lowering low-density lipoprotein-cholesterol on regression of coronary atherosclerotic plaques using intravascular ultrasound. At baseline there were 104 patients in group A and 103 in group B. 2015 Nov 15;116(10):1521-6. doi: 10.1016/j.amjcard.2015.08.010. Lipitor (atorvastatin) and Crestor (rosuvastatin) are HMG-CoA reductase inhibitors (“statin” drugs) that lower cholesterol levels in the blood. Patients with de novo coronary artery disease requiring intervention were randomized to rosuvastatin 10mg (R10) or atorvastatin 20mg (A20) daily. However, this trial was open-label and conducted in only one center which makes its methodology not very robust. At 16 weeks, there was a 40% reduction with rosuvastatin and 34% reduction with atorvastatin. It is an acute phase reactant and has been predicting both primary and secondary risks of a CV event. However, the differences were not statistically significant between the groups [14]. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Prevalence of thin-cap fibroatheroma significantly decreased in the R10 and A20 groups (-48% and -53%, respectively, p <0.001 for intragroup comparisons). Statins have shown striking results in reducing hs-CRP levels in patients with ACS. Group A showed mean 16% decrease in ESR levels as compared to 14% decrease in group B. Rosuvastatin showed a 50% decrease and atorvastatin showed a 35% reduction in serum hs-CRP levels in statin-naive ACS patients. In another meta-analysis, rosuvastatin displayed a more pronounced effect in reducing LDL than atorvastatin (P < 0.001), but not in increasing HDL (P = 0.22) and reducing hs-CRP (P = 0.68) [10]. Comparison of Intensive Versus Moderate Lipid-Lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-Rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging. In another randomized double-blind trial, there was a statistically significant reduction in hs-CRP levels with both atorvastatin and rosuvastatin. Epub 2015 Dec 13. Rosuvastatin has a more effective role in reducing micro-inflammation in ACS patients. Group A received 40 mg rosuvastatin daily and group B received 20 mg atorvastatin daily along with their standard regime which included aspirin, clopidogrel, beta-blocker, nitrates, and an angiotensin-converting enzyme inhibitor. The literature regarding the superiority of either statin in the reduction of pro-inflammatory markers is not concrete. Please note that Cureus is not responsible for any content or activities contained within our partner or affiliate websites. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature, Comparative effect of atorvastatin and rosuvastatin on 25-hydroxy-vitamin D levels in non-diabetic patients with dyslipidaemia: a prospective randomized open-label pilot study, 10.2174/187419240140801005510.2174/187419240140801005510.2174/187419240140801005510.2174/187419240140801005510.2174/187419240140801005510.2174/187419240140801005510.2174/1874192401408010055, Comparison of effectiveness of rosuvastatin versus atorvastatin on the achievement of combined C-reactive protein (< 2 mg/L) and low-density lipoprotein cholesterol (< 70 mg/dl) targets in patients with type 2 diabetes mellitus (from the ANDROMEDA study), Effects of atorvastatin and rosuvastatin on high-sensitivity C-reactive protein and lipid profile in obese type 2 diabetes mellitus patients, Comparison of anti-inflammatory effect of atorvastatin with rosuvastatin in patients of acute coronary syndrome, A comparative study on the effect of HMG-CoA reductase inhibitors on C-reactive protein in patients with acute coronary syndrome, 12-month follow-up results of high dose rosuvastatin loading before percutaneous coronary intervention in patients with acute coronary syndrome, Predictors of adverse outcome in patients with myocardial infarction with non-obstructive coronary artery (MINOCA) disease. In conclusion, although both statins demonstrated similar reductions in lipid profiles, the rosuvastatin group showed more rapid and robust plaque stabilization, and regression of plaque volume compared to the atorvastatin group. Anything above 5 should be considered above average. Statins also improve endothelial function, enhance ischemic vasodilatory response, and modulate inflammation [7-8]. ClinicalTrials.gov Identifier: NCT00214630: Recruitment … After a mean follow-up of 12 months, a major cardiovascular event (MACE) occurred in 20% controls (not receiving rosuvastatin) as compared to 9% in the rosuvastatin group (P< 0.05).

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