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

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2021 Jan 7

PMID 33409009

Citations 1

Authors

Salman Umrani

Waleed Jamshed

Amber Rizwan

Affiliations

Soon will be listed here.

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.

Citing Articles

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

de Liyis B, Jagannatha G, Kosasih A, Darma I, Artha I Egypt Heart J. 2024; 76(1):49.

PMID: 38630377 PMC: 11024076. DOI: 10.1186/s43044-024-00481-7.

References

Perez-Calahorra S, Laclaustra M, Marco-Benedi V, Pinto X, Sanchez-Hernandez R, Plana N . Comparative efficacy between atorvastatin and rosuvastatin in the prevention of cardiovascular disease recurrence. Lipids Health Dis. 2019; 18(1):216. PMC: 6905000. DOI: 10.1186/s12944-019-1153-x. View

Berwanger O, Santucci E, de Barros E Silva P, de Andrade Jesuino I, Damiani L, Barbosa L . Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome: The SECURE-PCI Randomized Clinical Trial. JAMA. 2018; 319(13):1331-1340. PMC: 5876881. DOI: 10.1001/jama.2018.2444. View

Patti G, Pasceri V, Colonna G, Miglionico M, Fischetti D, Sardella G . Atorvastatin pretreatment improves outcomes in patients with acute coronary syndromes undergoing early percutaneous coronary intervention: results of the ARMYDA-ACS randomized trial. J Am Coll Cardiol. 2007; 49(12):1272-8. DOI: 10.1016/j.jacc.2007.02.025. View

Leoncini M, Toso A, Maioli M, Tropeano F, Villani S, Bellandi F . Early high-dose rosuvastatin for contrast-induced nephropathy prevention in acute coronary syndrome: Results from the PRATO-ACS Study (Protective Effect of Rosuvastatin and Antiplatelet Therapy On contrast-induced acute kidney injury and myocardial.... J Am Coll Cardiol. 2013; 63(1):71-9. DOI: 10.1016/j.jacc.2013.04.105. View

Armstrong E, Morrow D, Sabatine M . Inflammatory biomarkers in acute coronary syndromes: part I: introduction and cytokines. Circulation. 2006; 113(6):e72-5. DOI: 10.1161/CIRCULATIONAHA.105.595520. View

Gencer B, Mach F . Lipid management in ACS: Should we go lower faster?. Atherosclerosis. 2018; 275:368-375. DOI: 10.1016/j.atherosclerosis.2018.06.871. View

Tousoulis D, Kampoli A, Stefanadi E, Antoniades C, Siasos G, Papavassiliou A . New biochemical markers in acute coronary syndromes. Curr Med Chem. 2008; 15(13):1288-96. DOI: 10.2174/092986708784534965. View

Angeli F, Reboldi G, Mazzotta G, Garofoli M, Francesca Cerasa M, Verdecchia P . Statins in acute coronary syndrome: very early initiation and benefits. Ther Adv Cardiovasc Dis. 2012; 6(4):163-74. DOI: 10.1177/1753944712452463. View

Kumar B, Shah M, Kumar R, Kumar J, Memon A . Comparison of Atorvastatin and Rosuvastatin in Reduction of Inflammatory Biomarkers in Patients with Acute Coronary Syndrome. Cureus. 2019; 11(6):e4898. PMC: 6689481. DOI: 10.7759/cureus.4898. View

10.

Ramasamy I . Biochemical markers in acute coronary syndrome. Clin Chim Acta. 2011; 412(15-16):1279-96. DOI: 10.1016/j.cca.2011.04.003. View

11.

Biasucci L, Biasillo G, Stefanelli A . Inflammatory markers, cholesterol and statins: pathophysiological role and clinical importance. Clin Chem Lab Med. 2010; 48(12):1685-91. DOI: 10.1515/CCLM.2010.277. View

12.

Mani P, Puri R, Schwartz G, Nissen S, Shao M, Kastelein J . Association of Initial and Serial C-Reactive Protein Levels With Adverse Cardiovascular Events and Death After Acute Coronary Syndrome: A Secondary Analysis of the VISTA-16 Trial. JAMA Cardiol. 2019; 4(4):314-320. PMC: 6484785. DOI: 10.1001/jamacardio.2019.0179. View

13.

Mizuno Y, Jacob R, Mason R . Inflammation and the development of atherosclerosis. J Atheroscler Thromb. 2011; 18(5):351-8. DOI: 10.5551/jat.7591. View

14.

Toso A, Leoncini M, Maioli M, Tropeano F, Di Vincenzo E, Villani S . Relationship between inflammation and benefits of early high-dose rosuvastatin on contrast-induced nephropathy in patients with acute coronary syndrome: the pathophysiological link in the PRATO-ACS study (Protective Effect of Rosuvastatin and.... JACC Cardiovasc Interv. 2014; 7(12):1421-9. DOI: 10.1016/j.jcin.2014.06.023. View