Two widely used cholesterol-lowering medications, rosuvastatin (Crestor) and atorvastatin (Lipitor), were found to be equally effective at preventing heart attacks, strokes, death, and the need for heart procedures, according to a new study published in The BMJ. The study focused on individuals with existing coronary artery disease, a type of heart disease caused by plaque buildup in the arteries.
The study included 4,400 people with coronary artery disease, with participants randomly assigned to take either rosuvastatin or atorvastatin every day for three years. The researchers found similar rates of heart attack, stroke, death, and coronary revascularization, indicating that both drugs were equally effective in reducing heart-related events.
While rosuvastatin had a stronger ability to lower LDL cholesterol levels, it was associated with a slightly higher risk of developing type 2 diabetes compared to atorvastatin. High levels of LDL cholesterol increase the risk of heart disease and stroke, so medications like statins lower these levels to reduce the risk.
Dr. Ragavendra Baliga, a cardiologist at The Ohio State University Wexner Medical Center, explained that the study’s results support an earlier clinical trial that also found a modest risk of developing diabetes while taking rosuvastatin. However, the overall benefits of taking rosuvastatin still outweighed the risks of developing type 2 diabetes.
One strength of the study is that it included patients from South Korea, representing a population that may not be well-represented in clinical trials conducted in North America or Europe. However, since all participants were Asian, the results may not be applicable to other racial or ethnic groups.
Dr. Cheng-Han Chen, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center, emphasized that the study was relatively short-term and does not provide enough information to determine whether the increased risk of diabetes will hold up in a more diverse population. He also pointed out that both medications are generally well-tolerated, and the fear of side effects should not deter people from taking beneficial statins.
In clinical practice, many cardiologists treat rosuvastatin and atorvastatin interchangeably. However, some individuals may have better outcomes or fewer side effects with one medication over the other. Chen highlighted the importance of listening to patients’ experiences and quickly switching them to an alternative if they report adverse reactions.
Overall, the study confirms that rosuvastatin and atorvastatin are similarly effective in preventing heart-related events. However, additional research is needed to further investigate the potential risks associated with rosuvastatin, such as the higher risk of new-onset diabetes and cataract surgery.