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Review
. 2024 Sep 4;16(9):e68602.
doi: 10.7759/cureus.68602. eCollection 2024 Sep.

Comparison of Efficacy of Atorvastatin and Rosuvastatin in Patients With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Darab Shuja  1 , Muhammad Umar Mian  2 , Manpreet Kaur Dhanjal  3 , Jaina Mengar  4 , Aqsa A Butt  5 , Sandipkumar S Chaudhari  6   7 , Calvin R Wei  8 , Areeba Khan  9
Affiliations
Review

Comparison of Efficacy of Atorvastatin and Rosuvastatin in Patients With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Darab Shuja et al. Cureus. .

Abstract

Acute coronary syndrome (ACS) remains a leading cause of morbidity and mortality worldwide. Statins, particularly atorvastatin, and rosuvastatin, are crucial in managing cholesterol levels and reducing cardiovascular risk in ACS patients. However, direct comparative studies between these two statins are limited. This meta-analysis aimed to compare the efficacy of atorvastatin and rosuvastatin in reducing major adverse cardiovascular events (MACE) and all-cause mortality in patients with ACS. A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, and Scopus for studies published up to July 2024. Randomized controlled trials and observational studies directly comparing atorvastatin and rosuvastatin in ACS patients were included. The primary outcomes were the incidence of MACE and all-cause mortality. Six studies involving 4195 patients were included in the meta-analysis. Pooled analysis showed no statistically significant difference between atorvastatin and rosuvastatin in reducing MACE [risk ratio (RR): 0.91, 95% confidence interval (CI): 0.68 to 1.22, p-value: 0.54] or all-cause mortality (RR: 0.94, 95% CI: 0.52 to 1.70, p-value: 0.83). No significant heterogeneity was observed among the studies (I-square: 0% for both outcomes). This meta-analysis suggests that atorvastatin and rosuvastatin have comparable efficacy in reducing MACE and all-cause mortality in ACS patients. These findings provide clinicians with flexibility in choosing between these statins based on individual patient factors. However, further large-scale randomized controlled trials are needed to confirm these results and explore potential differences in specific patient subgroups.

Keywords: acute coronary syndrome; atorvastatin; mace; rosuvastatin; systematic review and meta-analysis.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flowchart demonstrating the study selection process
Figure 2
Figure 2. Comparison of incidence of MACE between atorvastatin and rosuvastatin
Figure 3
Figure 3. Comparison of incidence of death between atorvastatin and rosuvastatin
See this image and copyright information in PMC

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