Coronary disease & ACSSecondary analysis
Rosuvastatin versus atorvastatin treatment in adults with coronary artery disease: secondary analysis of the randomised LODESTAR trial
- Secondary analysis of the LODESTAR randomised trial
- open label
- multicentre
- 2×2 factorial randomisation
- 12 hospitals in South Korea
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
Primary result
As reported in the abstract
Hazard ratio
1.06
95% CI 0.86–1.30
P = 0.58
Events by treatment group
Rosuvastatin vs 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
| Outcome | Rosuvastatin | Atorvastatin | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| New-onset DM requiring initiation of antidiabetics | 7.2% | 5.3% | 1.39 (1.03–1.87) | P = 0.03 | |
| Cataract surgery | 2.5% | 1.5% | 1.66 (1.07–2.58) | P = 0.02 | |
| 0.20.5125Hazard ratio (log scale) |
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
Summarised from the published abstract; every number is checked against it