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Rosuvastatin versus atorvastatin treatment in adults with coronary artery disease: secondary analysis of the randomised LODESTAR trial

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dc.contributor.author고영국-
dc.contributor.author김병극-
dc.contributor.author김중선-
dc.contributor.author안철민-
dc.contributor.author이승준-
dc.contributor.author이용준-
dc.contributor.author최동훈-
dc.contributor.author홍명기-
dc.contributor.author홍범기-
dc.contributor.author홍성진-
dc.date.accessioned2023-11-28T03:16:38Z-
dc.date.available2023-11-28T03:16:38Z-
dc.date.issued2023-10-
dc.identifier.issn0959-8138-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/196779-
dc.description.abstractObjective: To compare the long term efficacy and safety of rosuvastatin with atorvastatin treatment in adults with coronary artery disease. Design: Randomised, open label, multicentre trial. Setting: 12 hospitals in South Korea, September 2016 to November 2019. Participants: 4400 adults (age ≥19 years) with coronary artery disease. Interventions: Participants were assigned to receive either rosuvastatin (n=2204) or atorvastatin (n=2196) using 2×2 factorial randomisation. Main outcome measures: The primary outcome was a three year composite of all cause death, myocardial infarction, stroke, or any coronary revascularisation. Secondary outcomes were safety endpoints: new onset diabetes mellitus; hospital admissions due to heart failure; deep vein thrombosis or pulmonary thromboembolism; endovascular revascularisation for peripheral artery disease; aortic intervention or surgery; end stage kidney disease; discontinuation of study drugs owing to intolerance; cataract surgery; and a composite of laboratory detected abnormalities. Results: 4341 of the 4400 participants (98.7%) completed the trial. Mean daily dose of study drugs was 17.1 mg (standard deviation (SD) 5.2 mg) in the rosuvastatin group and 36.0 (12.8) mg in the atorvastatin group at three years (P<0.001). The primary outcome occurred in 189 participants (8.7%) in the rosuvastatin group and 178 (8.2%) in the atorvastatin group (hazard ratio 1.06, 95% confidence interval 0.86 to 1.30; P=0.58). The mean low density lipoprotein (LDL) cholesterol level during treatment was 1.8 mmol/L (SD 0.5 mmol/L) in the rosuvastatin group and 1.9 (0.5) mmol/L in the atorvastatin group (P<0.001). The rosuvastatin group had a higher incidence of new onset diabetes mellitus requiring initiation of antidiabetics (7.2% v 5.3%; hazard ratio 1.39, 95% confidence interval 1.03 to 1.87; P=0.03) and cataract surgery (2.5% v 1.5%; 1.66, 1.07 to 2.58; P=0.02). Other safety endpoints did not differ between the two groups. Conclusions: In adults with coronary artery disease, rosuvastatin and atorvastatin showed comparable efficacy for the composite outcome of all cause death, myocardial infarction, stroke, or any coronary revascularisation at three years. Rosuvastatin was associated with lower LDL cholesterol levels but a higher risk of new onset diabetes mellitus requiring antidiabetics and cataract surgery compared with atorvastatin.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherBritish Medical Association-
dc.relation.isPartOfBMJ-BRITISH MEDICAL JOURNAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAdult-
dc.subject.MESHAtorvastatin* / adverse effects-
dc.subject.MESHCataract-
dc.subject.MESHCholesterol, LDL-
dc.subject.MESHCoronary Artery Disease* / drug therapy-
dc.subject.MESHDiabetes Mellitus-
dc.subject.MESHHumans-
dc.subject.MESHHydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects-
dc.subject.MESHMyocardial Infarction-
dc.subject.MESHRosuvastatin Calcium* / adverse effects-
dc.subject.MESHStroke-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHYoung Adult-
dc.titleRosuvastatin versus atorvastatin treatment in adults with coronary artery disease: secondary analysis of the randomised LODESTAR trial-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorYong-Joon Lee-
dc.contributor.googleauthorSung-Jin Hong-
dc.contributor.googleauthorWoong Chol Kang-
dc.contributor.googleauthorBum-Kee Hong-
dc.contributor.googleauthorJong-Young Lee-
dc.contributor.googleauthorJin-Bae Lee-
dc.contributor.googleauthorHyung-Jin Cho-
dc.contributor.googleauthorJunghan Yoon-
dc.contributor.googleauthorSeung-Jun Lee-
dc.contributor.googleauthorChul-Min Ahn-
dc.contributor.googleauthorJung-Sun Kim-
dc.contributor.googleauthorByeong-Keuk Kim-
dc.contributor.googleauthorYoung-Guk Ko-
dc.contributor.googleauthorDonghoon Choi-
dc.contributor.googleauthorYangsoo Jang-
dc.contributor.googleauthorMyeong-Ki Hong-
dc.contributor.googleauthorLODESTAR investigators-
dc.identifier.doi10.1136/bmj-2023-075837-
dc.contributor.localIdA00127-
dc.contributor.localIdA00493-
dc.contributor.localIdA00961-
dc.contributor.localIdA02269-
dc.contributor.localIdA02927-
dc.contributor.localIdA02984-
dc.contributor.localIdA04053-
dc.contributor.localIdA04391-
dc.contributor.localIdA04394-
dc.contributor.localIdA04403-
dc.relation.journalcodeJ00419-
dc.identifier.eissn1756-1833-
dc.identifier.pmid37852649-
dc.contributor.alternativeNameKo, Young Guk-
dc.contributor.affiliatedAuthor고영국-
dc.contributor.affiliatedAuthor김병극-
dc.contributor.affiliatedAuthor김중선-
dc.contributor.affiliatedAuthor안철민-
dc.contributor.affiliatedAuthor이승준-
dc.contributor.affiliatedAuthor이용준-
dc.contributor.affiliatedAuthor최동훈-
dc.contributor.affiliatedAuthor홍명기-
dc.contributor.affiliatedAuthor홍범기-
dc.contributor.affiliatedAuthor홍성진-
dc.citation.volume383-
dc.citation.startPagee075837-
dc.identifier.bibliographicCitationBMJ-BRITISH MEDICAL JOURNAL, Vol.383 : e075837, 2023-10-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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