Statins are medications that are used to lower LDL cholesterol levels by inhibiting an enzyme termed HMG-CoA reductase. Elevated cholesterol levels have been shown to contribute to the development of cardiovascular and cerebrovascular disease. Thus, the use of statin medications to lower LDL cholesterol levels is a treatment used by physicians to help prevent cardiovascular and cerebrovascular disease, which lead to heart attack and stroke. The best selling pharmaceutical medication in history has been a statin medication named atorvastatin (Lipitor). Lipitor is on the verge of becoming available as a generic medication, which will make it affordable for many more people. A competing statin in the treatment of dyslipidemia is rosuvastatin (Crestor). There have been only a few studies to investigate the ability of intensive statin therapy on regression of coronary artery disease. Researchers, lead by Dr. Stephen Nicholls, have shown that atorvastatin and rosuvastatin are equal in their ability to cause regression of atheroma volume in coronary artery disease. The results of the SATURN trial (The Study of Coronary Atheroma by InTravascular Ultrasound: Effect of Rosuvastatin versus AtorvastatiN) were published online in the New England Journal of Medicine and presented at the scientific sessions of the American Heart Association meeting in Orlando, Florida. The researchers performed serial intravascular ultrasonography (IVUS) in 1,039 patients with coronary artery disease at the start of the study and after 104 weeks of treatment with either 80mg of atorvastatin or 40mg of rosuvastatin. After 104 weeks, the rosuvastatin group had statistically significant lower levels of LDL cholesterol and higher levels of HDL cholesterol. Both statins decreased the percent of atheroma volume (PAV) in coronary artery disease by an equal amount (0.99% with atorvastatin, 1.22% with rosuvastatin), and both agents induced regression in most patients. The authors wrote, “Although the current comparative study does not show a significant difference between the treatment groups with regard to the primary end point, it does show that high-dose, intensive statin therapy can be administered safely and can promote regression of atherosclerotic plaque to a greater extent than has previously been reported. These findings represent a useful step forward in the effort to prevent the devastating clinical sequelae of atherosclerotic cardiovascular disease”. These study results are particular relevant because on November 30, Lipitor will become generically available at a markedly cheaper price than Crestor.
See the YouTube Video with Dr. Stephen Nicholls regarding the study results:
Stephen J. Nicholls et al. “Effect of Two Intensive Statin Regimens on Progression of Coronary Disease” New Engl J Med 2011; DOI:10.1056/NEJMoa1110874