1. 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
- Author
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Jean Marc Lablanche, Attilio, Leone, Bela, Merkely, Joao, Morais, Joaquim, Alonso, Massimo, Santini, Jaan, Eha, Nacima, Demil, Muriel, Licour, Jean Claude Tardif, Fealbert, Centaurus Investigators: F., Alonso Martin, J., Asseman, P., Aymong, E., Ballout, J., Bardaji Ruiz, A., Bayet, G., Bearez, E., Belle, L., Benit, E., Berlemont, C., Bertomeu, V., Blanchard, D., Bonnet, J. L., Boughalem, K., Boughzela, E., Boujnah, M. R., Buffon, A., Cardoso, A., Cardoso, P., Cavallini, C., Celen, H., Cohen, A. A., Constance, C., Coste, P., Crean, P., Crochet, P. D., Czarnecki, W., Danchin, N., Davy, J. M., Decoulx, E., Delarche, N., De Luca, I., Dubois, P., Dubois Rande, J. L., Dubourg, O., Ducas, J., Dzavik, V., Eha, J., Allaf D., El, Elhadad, S., El Mansour, N., Farah, B., Fedele, Francesco, Fernandez Aviles, F. J., Ferreira, J., Foley, D., Fong, P., Gacem, K., Garber, P., Garcia, V. L., Gendreau, R., Ghanem, N., Goulet, G., Grollier, G., Guiomard, A., Gully, C., Habis, M., Haouala, H., Henry, P., Heyndrickx, G., Horvath, I., Hui, W., Huynh Thanh, T., Iliceto, S., Iniguez Romo, A., Jamal, F., Janssens, L., Jimenez Mena, M., Kallikazaros, I., Kassam, S., Kermarrec, A., Khalife, K., Kim, H., Kiss, R. G., Klinke, W. P., Koning, R., Kouz, S., Kyriakides, Z., L'Abbate, A., Labonte, R., Lahaye, S., Leborgne, L., Le May, M., Leone, A., Lepage, S., Lupkovics, G., Martinez Martinez, A., Meany, B., Mechmech, R., Melchior, J. P., Merkely, B., Metz, D., Mimoso, J., Montalescot, G., Morais, J., Moreira, I., Mougeot, G., Mulcahy, D., Nanas, J., Nash, P., Nugue, O., Rodriguez, Padial L., Paganelli, F., Palaic, M., Pereira, L. M., Pitscheider, W., Presbitero, P., Puel, J., Radhakrishnan, S., Reeves, F., Richter, D., Rodes, Cabau J., Rosak, P., Rose, B., Rousseau, J. F., Santini, M., Schampaert, E., Scherillo, M., Serrano Aisa, P., Sugrue, D., Tamburino, C., Tardif, J. C., Teefy, P., Timmerman, P., Title, L., Traisnel, G., Tremblay, B., Tremblay, G., Trimarco, B., Tymchak, W., Vándor, L., Vassanelli, C., Veress, G., Voitk, J., Wolf, J. E., Wong, G., Zámolyi, K., Zanini, R., and Zimmermann, R.
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Male ,medicine.medical_specialty ,Acute coronary syndrome ,acute coronary syndrome ,apolipoproteins ,cholesterol ,statins ,Apolipoprotein B ,Atorvastatin ,Gastroenterology ,chemistry.chemical_compound ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Multicenter Studies as Topic ,Rosuvastatin ,Pyrroles ,Acute Coronary Syndrome ,Angioplasty, Balloon, Coronary ,Rosuvastatin Calcium ,Aged ,Apolipoproteins B ,Sulfonamides ,biology ,Apolipoprotein A-I ,business.industry ,Cholesterol ,nutritional and metabolic diseases ,General Medicine ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Fluorobenzenes ,Endocrinology ,Pyrimidines ,Treatment Outcome ,chemistry ,Heptanoic Acids ,biology.protein ,lipids (amino acids, peptides, and proteins) ,Female ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Cardiology and Cardiovascular Medicine ,Lipoprotein ,medicine.drug - Abstract
Summary 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 ∼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.
- Published
- 2009