Coronary disease & ACS

Rosuvastatin versus atorvastatin treatment in adults with coronary artery disease: secondary analysis of the randomised LODESTAR trial

BMJPublished Secondary analysis of the LODESTAR randomised trial

Primary resultResult — go to the resultHazard ratio 1.06 95% CI 0.86–1.30

Authors' conclusion

In adults with coronary artery disease, rosuvastatin and atorvastatin showed comparable efficacy for the composite outcome of all cause death, myocardial infarction, stroke, or any coronary revascularisation at three years. Rosuvastatin was associated with lower LDL cholesterol levels but a higher risk of new onset diabetes mellitus requiring antidiabetics and cataract surgery compared with atorvastatin.

Study context

Population
Adults (age ≥19 years) with CAD, South Korea, September 2016 to November 20194,341 (98.7%) completed
Participants
4,400 adults
Comparison
Rosuvastatin vs atorvastatin
  • Rosuvastatinn = 2,204
  • Atorvastatinn = 2,196reference
Primary endpoint
Composite of:
  • All-cause death
  • MI
  • Stroke
  • Any coronary revascularisation
Follow-up
3 years
Methodological detailsopen label, multicentre, 2×2 factorial randomisation, 12 hospitals in South Korea
  • Open label
  • Multicentre
  • 2×2 factorial randomisation
  • 12 hospitals in South Korea

Primary result

As reported in the abstract

Hazard ratio

1.06

95% CI 0.86–1.30

P = 0.58

Events by treatment group

Rosuvastatinvs Atorvastatin
HR 1.06 (95% CI 0.86–1.30); P = 0.58

Secondary outcomes

Mean LDL-C during treatment

Mean daily dose of study drugs · 3 years

  • Mean LDL-C during treatment: P<0.001
  • Mean daily dose of study drugs: P<0.001

Safety

OutcomeRosuvastatinAtorvastatinHR (95% CI)P value
New-onset DM requiring initiation of antidiabetics7.2%5.3%1.39 (1.03–1.87)P = 0.03
Cataract surgery2.5%1.5%1.66 (1.07–2.58)P = 0.02

Other safety endpoints

Did not differ between the two groups

Original publication

Rosuvastatin versus atorvastatin treatment in adults with coronary artery disease: secondary analysis of the randomised LODESTAR trial. BMJ. Published 18 October 2023. doi:10.1136/bmj-2023-075837

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