Get the latest public health information from CDC: https://www.coronavirus.gov. Impact of Water- and Lipid-Soluble Statins on Nonculprit Lesions in Patients with Acute Coronary Syndrome. Compared to moderate/low dose, statins in high dose can elicit better cardiovascular outcome among established CVD cases [ 11 – 16 ]. The difference was statistically significant (p<0.0001). Only the R10 group had a decrease in macrophage density (-23%, p = 0.04) and microvessels (-12%, p = 0.002). Scholarly Impact Quotient™ (SIQ™) is our unique post-publication peer review rating process. Whether all statins have similar effects on plaque stabilization is unknown. Epub 2015 Dec 13. The American Chemical Society holds a copyright ownership interest in any copyrightable Supporting Information. From baseline to 6 months to 12 months, minimum fibrous cap thickness increased in the R10 group (61.4 ± 15.9 µm to 120.9 ± 57.9 µm to 171.5 ± 67.8 µm, p <0.001) and the A20 group (60.8 ± 18.1 µm to 99.2 ± 47.7 µm to 127.0± 66.8 µm, p <0.001). We took consent from all patients, and the study was approved by the ethical review committee of the institute. While the choice of statin has been controversial with some literature supporting atorvastatin and other supporting rosuvastatin; the role of rosuvastatin has been more beneficial. Hs-CRP levels were measured using Turbox hs-CRP kit (for protein analyzer Turbox plus) by turbidimetry method. In the Statin Therapies for Elevated Lipid Levels compared Across doses to Rosuvastatin (STELLAR) trial, the efficacy of rosuvastatin calcium (Crestor) was compared with that of atorvastatin (Lipitor), simvastatin (Zocor), and pravastatin (Pravachol) for lowering plasma low-density lipoprotein cholesterol (LDL-C) after 6 weeks of treatment. Epub 2012 Mar 20. (June 14, 2019) Comparison of Atorvastatin and Rosuvastatin in Reduction of Inflammatory Biomarkers in Patients with Acute Coronary Syndrome. In a recent meta-analysis, including patients with acute coronary syndrome (ACS), it was deduced that patients with moderately elevated hs-CRP (3.1-10 mg/dL) and severely elevated hs-CRP (>10mg/dL) have 1.40 times and 2.18 times greater long-term risk of recurrent CV events or even death respectively [3]. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. P value ≤0.05 was taken as significant. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. However, the differences were not statistically significant between the groups [14]. Patients who were surgically managed were also excluded. : Tousoulis D, Psarros C, Demosthenous M, Patel R, Antoniades C, Stefanadis C: Qian C, Wei B, Ding J, Wu H, Cai X, Li B, Wang Y: Anagnostis P, Adamidou F, Slavakis A, et al. Each email address must be separated by a comma. Rosuvastatin was also studied as pre-treatment before percutaneous coronary intervention (PCI) following myocardial infarction. In group A, there was a mean 51% decrease in hs-CRP levels, and in group B, a 35% reduction was seen. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Read our disclaimer for details. With four weeks of treatment, both rosuvastatin and atorvastatin showed a statistically significant reduction in serum hs-CRP levels (p<0.0001). Rosuvastatin showed a 50% decrease in serum hs-CRP levels and atorvastatin showed a 35% reduction. Both groups showed a statistically significant reduction in ESR and hs-CRP levels at four weeks within groups as well as between groups. Cureus 11(6): e4898.  |  Khurana et al. Group A showed mean 16% decrease in ESR levels as compared to 14% decrease in group B. Forty-three patients completed the protocol (R10: 24 patients, 31 plaques; A20: 19 patients, 30 plaques). This deduces that the patients should’ve followed the treatment for a longer duration to reach the safe limits of hs-CRP. Epub 2015 Sep 1. ESR was measured using Westergren method. We correlated the means within each group (baseline vs. four weeks) by applying dependent T-test and within the two groups (at four weeks of group A vs. group B) by applying independent T-test. Group A showed lower ESR levels than group B after four weeks of therapy (19.59 ± 11.83 vs. 20.52 ± 12.13) (p<0.0001). When inter-group comparison was done, only the change in mean VLDL and TGs was statistically significant (p<0.05). Group A received 40 mg rosuvastatin daily and group B received 20 mg atorvastatin daily along with their standard regime which included aspirin, clopidogrel, beta-blocker, nitrates, and an angiotensin-converting enzyme inhibitor. Cureus 11(6): e4898. It was an open-label trial which showed that hs-CRP levels were significantly decreased after four weeks in both rosuvastatin and atorvastatin groups (P < 0.001). Human subjects: Consent was obtained by all participants in this study. Learn more here. The Benjo study below noted that in the subset of NSTEMI patients, the dosing of statins used was atorvastatin (80mg) or rosuvastatin (20mg or 40mg). In conclusion, although both statins demonstrated similar reductions in lipid profiles, the rosuvastatin group showed more rapid and robust plaque stabilization, and regression of plaque volume compared to the atorvastatin group. The literature regarding the superiority of either statin in the reduction of pro-inflammatory markers is not concrete. In this prospective, open-label randomized trial, group A was given rosuvastatin 40 mg daily and group B was given atorvastatin 20 mg daily along with standard post-ACS therapy. Terms of Use. Peer review concluded: June 02, 2019 Listing a study does not mean it has been evaluated by the U.S. Federal Government. We also excluded pregnant or lactating women. As seen in Table 3, in both rosuvastatin and atorvastatin groups, a mean favorable change was observed in total cholesterol (TC), low density lipoprotein (LDL), very low density lipoprotein (VLDL), and triglycerides (TGs) that was statistically significant over a period of four weeks (p<0.05). In another study with obese type 2 diabetic patients, both atorvastatin and rosuvastatin significantly reduced hs-CRP levels; however, the differences were not significant between the groups [15]. After a mean follow-up of 12 months, a major cardiovascular event (MACE) occurred in 20% controls (not receiving rosuvastatin) as compared to 9% in the rosuvastatin group (P< 0.05). The decrease in serum lipids was similar. Ishikawa Y, Itoh T, Satoh M, Fusazaki T, Sugawara S, Nakajima S, Nakamura M, Morino Y. Int Heart J. NLM Rosuvastatin showed a 50% decrease in serum hs-CRP levels and atorvastatin showed a 35% reduction. When tested between the groups, rosuvastatin showed significantly lower hs-CRP levels than atorvastatin at the end of the study. It has also been suggested in the research that elevated levels of inflammatory biomarkers - hs-CRP and erythrocyte sedimentation rate (ESR) - point towards subclinical atherosclerosis long before a major acute coronary event occurs [1-2]. Group A showed markedly low hs-CRP levels than group B after four weeks of therapy (18.46 ± 6.35 vs. 24.67 ± 8.45) (p<0.0001). This study has evaluated that although the lipid-lowering effects of atorvastatin and rosuvastatin are comparable, the latter has a more profound impact on the reduction of pro-inflammatory markers, especially hs-CRP, which is an established predictor of cardiovascular morbidity and mortality.