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,  Clinical Article

Lee CW et al. – 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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