Comparison of effects of atorvastatin (20 mg) versus rosuvastatin (10 mg) therapy on mild coronary atherosclerotic plaques (from the artmap trial)

The American Journal of Cardiology, 06/01/2012

Usual doses of atorvastatin and rosuvastatin induced significant regression of coronary atherosclerosis in statin–naive patients, with a greater decrease in favor of rosuvastatin.

Methods

  • Authors 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.

Results

  • 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.

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