Rosuvastatin not superior to Atorvastatin among patients with coronary artery disease: LODESTAR TRIAL

Patients with pregnancy, Intolerance to statin or use of a medication that interacts with statin metabolism, risk for myopathy, limited life expectancy and low-density lipoprotein cholesterol (LDL-C) at enrollment, i.e 86 mg/dL were excluded.

The key findings of the study are

• The primary outcome such as death, stroke, myocardial infarction, or revascularization at 3 years, was 8.7% in the rosuvastatin group vs. 8.2% in the atorvastatin group (p = 0.58).

• High-intensity statin therapy dosing was achieved in 70.9% of the rosuvastatin group vs. 74.0% of the atorvastatin group (p = 0.022)

• LDL-C level <70 mg/dL at 3 years: 62.5% of the rosuvastatin group vs. 55.2% of the atorvastatin group (p < 0.001).

• Death at 3 years: 2.6% in the rosuvastatin group vs. 2.3% in the atorvastatin group (p = 0.57).

• Myocardial infarction at 3 years: 1.5% in the rosuvastatin group vs. 1.2% in the atorvastatin group (p = 0.37).

• Initiation of diabetic medication: 7.2% in the rosuvastatin group vs. 5.3% in the atorvastatin group (p = 0.031).

• Cataract operation: 2.5% in the rosuvastatin group vs. 1.5% in the atorvastatin group (p = 0.022)

The researchers ended that among patients with coronary artery disease, rosuvastatin was not superior to atorvastatin at preventing adverse cardiac events within 3 years. This lack of benefit was despite a higher frequency of subjects achieving LDL-C level <70 mg/dL at 3 years in the rosuvastatin group versus the atorvastatin group.

Reference: Anthony A. Bavry, MD, MPH, FACC; Rosuvastatin vs. Atorvastatin Treatment in Patients With Coronary Artery Disease – LODESTAR, Aug 25, 2023, Americ. Col. Cardio. Doi: https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2023/08/23/19/37/lodestar.