Background. The mechanism underlying statin-induced event reduction in patients with acute coronary syndrome remains unclear. Aims. To assess the efficacy of rosuvastatin 20 mg versus atorvastatin 80 mg in reducing the apolipoprotein B/apolipoprotein A-1 (apoB/apoA-1) ratio at 3 months. Non-inferiority of rosuvastatin 20 mg versus atorvastatin 80 mg in reducing low-density lipoprotein cholesterol at 1 and 3 months was also assessed. Methods. Patients with non-ST-elevation acute coronary syndrome were enrolled into this randomized, double blind, parallel-group trial. Results. In total, 753 patients (369, rosuvastatin 20 mg; 384, atorvastatin 80 mg) were included in the intention-to-treat analysis; 478 patients (226, rosuvastatin 20 mg; 252, atorvastatin 80 mg) were included in the per-protocol analysis. Rosuvastatin 20 mg was more effective than atorvastatin 80 mg in decreasing apoB/apoA-1 ratio at 1 month (-44.4% vs -42.9%, p = 0.02) but not at 3 months (both -44.4%, p = 0.87). Low-density lipoprotein cholesterol decreased by similar to 50% after 1 and 3 months in both groups. Non-inferiority of rosuvastatin 20 mg versus atorvastatin 80 mg was demonstrated at 1 month (difference, -0.3% [95% confidence interval, -2.7; +2.1]), but not at 3 months (+1.0% [-1.6; 3.5]) (intention-to-treat analysis). In the per-protocol analysis, non-inferiority of rosuvastatin 20 mg was demonstrated at both 1 (-0.7% [-3.5; 2.0]) and 3 (-0.5% [-3.5; 2.5]) months. Conclusion. In patients with non-ST-elevation acute coronary syndrome, rosuvastatin 20 mg decreased apoB/apoA-1 ratio at 1 month more than atorvastatin 80 mg. No difference could be shown at 3 months; thus, the primary endpoint was not met. (C) 2010 Published by Elsevier Masson SAS.
Comparison of the efficacy of rosuvastatin versus atorvastatin in reducing apolipoprotein B/apolipoprotein A-1 ratio in patients with acute coronary syndrome: Results of the CENTAURUS study / Jean Marc, Lablanche; Attilio, Leone; Bela, Merkely; Joao, Morais; Joaquim, Alonso; Massimo, Santini; Jaan, Eha; Nacima, Demil; Muriel, Licour; Jean Claude, Tardif; Centaurus Investigators: F., Fealbert; J., Alonso Martin; P., Asseman; E., Aymong; J., Ballout; A., Bardaji Ruiz; G., Bayet; E., Bearez; L., Belle; E., Benit; C., Berlemont; V., Bertomeu; D., Blanchard; J. L., Bonnet; K., Boughalem; E., Boughzela; M. R., Boujnah; A., Buffon; A., Cardoso; P., Cardoso; C., Cavallini; H., Celen; A. A., Cohen; C., Constance; P., Coste; P., Crean; P. D., Crochet; W., Czarnecki; N., Danchin; J. M., Davy; E., Decoulx; N., Delarche; I., De Luca; P., Dubois; J. L., Dubois Rande; O., Dubourg; J., Ducas; V., Dzavik; J., Eha; Allaf D., El; S., Elhadad; N., El Mansour; B., Farah; Fedele, Francesco; F. J., Fernandez Aviles; J., Ferreira; D., Foley; P., Fong; K., Gacem; P., Garber; V. L., Garcia; R., Gendreau; N., Ghanem; G., Goulet; G., Grollier; A., Guiomard; C., Gully; M., Habis; H., Haouala; P., Henry; G., Heyndrickx; I., Horvath; W., Hui; T., Huynh Thanh; S., Iliceto; A., Iniguez Romo; F., Jamal; L., Janssens; M., Jimenez Mena; I., Kallikazaros; S., Kassam; A., Kermarrec; K., Khalife; H., Kim; R. G., Kiss; W. P., Klinke; R., Koning; S., Kouz; Z., Kyriakides; A., L'Abbate; R., Labonte; S., Lahaye; L., Leborgne; M., Le May; A., Leone; S., Lepage; G., Lupkovics; A., Martinez Martinez; B., Meany; R., Mechmech; J. P., Melchior; B., Merkely; D., Metz; J., Mimoso; G., Montalescot; J., Morais; I., Moreira; G., Mougeot; D., Mulcahy; J., Nanas; P., Nash; O., Nugue; Padial L., Rodriguez; F., Paganelli; M., Palaic; L. M., Pereira; W., Pitscheider; P., Presbitero; J., Puel; S., Radhakrishnan; F., Reeves; D., Richter; Cabau J., Rodes; P., Rosak; B., Rose; J. F., Rousseau; M., Santini; E., Schampaert; M., Scherillo; P., Serrano Aisa; D., Sugrue; C., Tamburino; J. C., Tardif; P., Teefy; P., Timmerman; L., Title; G., Traisnel; B., Tremblay; G., Tremblay; B., Trimarco; W., Tymchak; L., Vándor; C., Vassanelli; G., Veress; J., Voitk; J. E., Wolf; G., Wong; K., Zámolyi; R., Zanini; R., Zimmermann. - In: ARCHIVES OF CARDIOVASCULAR DISEASES. - ISSN 1875-2136. - 103:3(2010), pp. 160-169. [10.1016/j.acvd.2010.01.005]
Comparison of the efficacy of rosuvastatin versus atorvastatin in reducing apolipoprotein B/apolipoprotein A-1 ratio in patients with acute coronary syndrome: Results of the CENTAURUS study
FEDELE, Francesco;
2010
Abstract
Background. The mechanism underlying statin-induced event reduction in patients with acute coronary syndrome remains unclear. Aims. To assess the efficacy of rosuvastatin 20 mg versus atorvastatin 80 mg in reducing the apolipoprotein B/apolipoprotein A-1 (apoB/apoA-1) ratio at 3 months. Non-inferiority of rosuvastatin 20 mg versus atorvastatin 80 mg in reducing low-density lipoprotein cholesterol at 1 and 3 months was also assessed. Methods. Patients with non-ST-elevation acute coronary syndrome were enrolled into this randomized, double blind, parallel-group trial. Results. In total, 753 patients (369, rosuvastatin 20 mg; 384, atorvastatin 80 mg) were included in the intention-to-treat analysis; 478 patients (226, rosuvastatin 20 mg; 252, atorvastatin 80 mg) were included in the per-protocol analysis. Rosuvastatin 20 mg was more effective than atorvastatin 80 mg in decreasing apoB/apoA-1 ratio at 1 month (-44.4% vs -42.9%, p = 0.02) but not at 3 months (both -44.4%, p = 0.87). Low-density lipoprotein cholesterol decreased by similar to 50% after 1 and 3 months in both groups. Non-inferiority of rosuvastatin 20 mg versus atorvastatin 80 mg was demonstrated at 1 month (difference, -0.3% [95% confidence interval, -2.7; +2.1]), but not at 3 months (+1.0% [-1.6; 3.5]) (intention-to-treat analysis). In the per-protocol analysis, non-inferiority of rosuvastatin 20 mg was demonstrated at both 1 (-0.7% [-3.5; 2.0]) and 3 (-0.5% [-3.5; 2.5]) months. Conclusion. In patients with non-ST-elevation acute coronary syndrome, rosuvastatin 20 mg decreased apoB/apoA-1 ratio at 1 month more than atorvastatin 80 mg. No difference could be shown at 3 months; thus, the primary endpoint was not met. (C) 2010 Published by Elsevier Masson SAS.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
