Key result
Atorvastatin significantly reduced high-sensitivity cardiac troponin-I levels by 21.8% at 18 weeks compared to a 4.1% reduction with rosuvastatin in patients with stable cardiovascular disease.
Why the study?
Does atorvastatin compared to rosuvastatin reduce hs-cTnI levels in patients with stable cardiovascular disease?
RCT (n=78)
Open-label
Randomized
Yes
Does atorvastatin compared to rosuvastatin reduce hs-cTnI levels in patients with stable cardiovascular disease?
Statin therapy rapidly reduces high-sensitivity troponin-I levels within 6 weeks in patients with stable cardiovascular disease, with atorvastatin showing a more pronounced effect than rosuvastatin at 18 weeks.
Supports atorvastatin preference for hs-cTnI reduction in stable CVD; extends comparative statin biomarker data pending outcome trials.
Serum troponin within the normal range is an emerging predictor of cardiovascular mortality. We aimed to determine how rapidly high-sensitivity troponin-I (hs-cTnI) levels are lowered by statin therapy in patients with stable cardiovascular disease. In the RADAR substudy, patients were randomized to atorvastatin 20 mg/day (n = 39) or rosuvastatin 10 mg/day (n = 39) and up-titrated at 6-week intervals to 80 mg of atorvastatin or 40 mg of rosuvastatin. Hs-cTnI concentrations were measured at baseline and at 6 and 18 weeks of follow-up. Statin treatment resulted in a mean change of serum hs-cTnI of -8.2% (P = 0.010) after 6 weeks and -12.3% (P = 0.001) after 18 weeks. After 18 weeks, hs-cTnI levels were lowered by 21.8% with atorvastatin and by 4.1% with rosuvastatin (P = 0.001 and P = 0.133, respectively). During statin therapy, serum hs-cTnI levels decreased rapidly within weeks of treatment, suggesting an effect beyond long-term atherosclerosis regression. Mechanisms that mediate this effect require further study.
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Bodde et al. (2018) conducted an RCT in Stable cardiovascular disease (n=78). Atorvastatin vs. Rosuvastatin 10 mg/day up-titrated to 40 mg/day was evaluated on Change in log high-sensitivity cardiac Troponin-I (hs-cTnI) levels from baseline to 18 weeks (mean log difference 0.09, p=0.022). Atorvastatin significantly reduced high-sensitivity cardiac troponin-I levels by 21.8% at 18 weeks compared to a 4.1% reduction with rosuvastatin in patients with stable cardiovascular disease.
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