Comparative Effects Between High-intensity Atorvastatin and Rosuvastatin on New Onset Diabetes Mellitus and Cardiovascular Outcome

Abstract

Background: High-intensity statin is typically used in patients with acute myocardial infarction (AMI) for secondary prevention; however, concern regarding its association with diabetes mellitus has been consistent. We investigated and compared the impact of high-intensity atorvastatin on new-onset diabetes mellitus (NODM) and cardiovascular outcomes with that of high-intensity rosuvastatin for a 3-year follow-up period. Methods: Data from the Korea Acute Myocardial Infarction Registry were collected from November 2011 to October 2015, and 13,104 AMI patients were enrolled from major cardiovascular centers. Among them, 2,221 patients without diabetes who had been administered with high-intensity atorvastatin (40–80 mg) and rosuvastatin (20 mg) were investigated. The atorvastatin and rosuvastatin groups were compared and evaluated for the incidence of NODM and major adverse cardiac event (MACE) including total death, myocardial infarction, and revascularization cases in the following 3 years.Results: Baseline characteristics were comparable between two groups. Event-free survival rate of NODM and MACE was not significantly different between the atorvastatin and rosuvastatin groups (92.5% vs. 90.8%, respectively; Log-rank P-value = 0.550). The event-free survival rate of MACE was also not significantly different between atorvastatin and rosuvastatin groups (89.0% vs. 89.6%, respectively; Log rank p-value = 0.662). Multivariable Cox analysis revealed that the statin type was not a prognostic factor in the development of NODM and MACE. Conclusions: Administering high-intensity atorvastatin and rosuvastatin in AMI patients produced comparable effects on NODM and clinical outcome, suggesting their clinical equivalence in secondary prevention.