Comparison of Atorvastatin and Rosuvastatin in Reduction of Inflammatory Markers in Acute Coronary Syndrome

Abstract

Introduction: Patients suffering from acute coronary syndrome (ACS) are found to have elevated levels of inflammatory markers such as high sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) in their blood. These elevated inflammatory markers can lead to complications in ACS. Statins such as atorvastatin and rosuvastatin are known to reduce inflammatory markers. Our aim is to compare the efficacy of atorvastatin and rosuvastatin in reducing inflammatory markers. Methods: This prospective, open-label, randomized trial was conducted in the cardiovascular department of tertiary care in a rural area of Pakistan. There were 128 patients diagnosed with ACS who were enrolled in the study. They were randomized into two groups, i.e. group A in which patients received 40 mg rosuvastatin daily and group B in which patients received 20 mg atorvastatin daily. hsCRP and ESR were recorded for all the patients at baseline (before starting therapy) and then again after four weeks. The results were compared between both groups. Result: Out of 128 patients, 113 (88.2%) patients completed the study. According to this study, at the end of four weeks, rosuvastatin reduced hsCRP (p value: < 0.0001) and ESR (p value: 0.015) values significantly more when compared with atorvastatin. Conclusion: In this study, rosuvastatin was significantly superior to atorvastatin in reducing inflammatory markers such as ESR and hsCRP in patients suffering from ACS. Cardiologists should consider using rosuvastatin rather than atorvastatin in management of patients suffering from ACS with elevated inflammatory biomarkers.

High Intensity Statins in Acute Coronary Syndrome Part II: A comparison of Atorvastatin and Rosuvastatin for use in ACS, Clinical trials in India and Place for statins in current guidelines

“…ROSUVEES-2 6 It can be concluded from the results of this study that 40 mg dose of rosuvastatin, initiated early and continued for 12 weeks, was effective in terms of reducing LDL cholesterol and was well tolerated. KARANCHI RCT's 7,8 Rosuvastatin led to a 50% decrease in HsCRP/ESR reduction. As compared to Atorvastatin which showed just 35% decrease.…”

“…Comparing atorvastatin and rosuvastatin, the latter was found more efficacious in mitigating micro-inflammation in ACS patients in RCT's performed in Karanchi. 7,8 Additionally, recurrent ASCVD events also indicate potential relations to reductions in inflammatory markers postinitial cardiovascular incident. Given the paramount role of statins, especially prevalent ones like atorvastatin and rosuvastatin, in tempering inflammatory markers and, in turn, reducing future cardiovascular events, their…”

Efficacy of single high-dose statin prior to percutaneous coronary intervention in acute coronary syndrome: a systematic review and meta-analysis

“…In the study by Lopes et al [ 25 ], high-dose atorvastatin significantly reduced MACE by up to 34% at 30 days (HR 0.66, 95% CI 0.48–0.98), but this benefit was observed primarily in the STEMI subtype and not in NSTE-ACS patients. Similarly, the greater benefit of rosuvastatin compared to atorvastatin in reducing MACE in the NSTE-ACS population may be attributed by rosuvastatin’s lower incidence of global and capillary inflammatory activities in ACS patients [ 41 ]. This improvement could translate into better clinical outcomes.…”