disease (CAD) is the most common type of heart disease.It is a leading cause of
death worldwide.This arises due to the deposition of cholesterol and other
materials, called plaque, on the inner walls of coronary arteries.Thus the
blood supply to the heart is compromised; muscles of the heart get deprived of
oxygen and nutrients.
rosuvastatin are cholesterol-lowering drugs used worldwide.A new study included 1,385
patients who took either 40 mg of rosuvastatin or 80 mg of atorvastatin daily
and were followed for two years.The amount of coronary artery plaque fell 0.99
percent with atorvastatin and 1.22 percent with rosuvastatin.The difference
between the two drugs is not statistically significant, researchers said.More than two-thirds of the
patients had regression of plaque.
usually hesitate to prescribe very high doses of these drugs; patients don't
like to take them because they doubt over the safety and added benefit of heavy
doses.The current study showed that high doses would be very well
tolerated and had a good safety profile.
Two years of treatment
with maximum dosages of either of the two statins brought significant regression of coronary artery
plaques.Very good lipid changes were also observed.
significant difference was noted in the average LDL (the 'bad' cholesterol)
levels of patients, following two years of treatment.The highest dose of drugs
however did not alter the HDL (the 'good' cholesterol) levels as expected.
The study showed a low number of clinical and
biochemical adverse events.Elevated liver enzyme levels were found in 2.0% of
the atorvastatin patients.An elevated alanine
aminotransferase level (ALT level) was noticed only in 0.7% of patients who
received rosuvastatin.Proteinuria, the presence of excessive protein in urine
was observed in patients who received rosuvastatin.Rhabdomyolysis (breakdown of
skeletal muscles) was not observed in any patient.Another significant
observation was that, there was no increase in glycated hemoglobin levels in
patients.Glycated hemoglobin level is an indicator of diabetes.The effect of statins
on the incidence of diabetes has received considerable attention recently; the
current study is hence promising.
Taken as a whole, the study indicates that intensive
statin treatment led to coronary artery disease regression with few adverse
events.The results highlight the safety of and need for intensive statin
Physicians may comfortably choose an intensive dosage of a
potent statin for patients with heart disease.It would be the most effective
way to reduce the risk for related complications.
The current study was a head-to-head comparison
of the two top statins.Atorvastatin was found to be statistically
indistinguishable from its somewhat more potent rival, rosuvastatin in most
Effect of Two Intensive
Statin Regimens on Progression of Coronary Disease; Stephen J.Nicholls, M.B.,
B.S., Ph.D., Christie M.Ballantyne, M.D., Philip J.Barter, M.B., B.S., Ph.D.,
M.John Chapman, Ph.D., D.Sc., Raimund M.Erbel, M.D., Peter Libby, M.D., Joel
S.Raichlen, M.D., Kiyoko Uno, M.D., Marilyn Borgman, R.N., Kathy Wolski,
M.P.H., and Steven E.Nissen, M.D.; N Engl J Med 2011; 365:2078-2087December 1, 2011