Leiter Lawrence A, Rosenson Robert S, Stein Evan, Reckless John P D, Schulte Karl-Ludwig, Schleman Margo, Miller Paul, Palmer Michael, Sosef Froukje
Division of Endocrinology and Metabolism, St. Michael's Hospital, University of Toronto, Toronto, Canada.
Atherosclerosis. 2007 Oct;194(2):e154-64. doi: 10.1016/j.atherosclerosis.2006.12.001. Epub 2007 Jan 16.
POLARIS investigated the efficacy and safety of rosuvastatin 40 mg and atorvastatin 80 mg in high-risk patients with hypercholesterolemia. Patients (n=871) were randomized to rosuvastatin 40 mg/day or atorvastatin 80 mg/day for 26 weeks. The primary endpoint was percentage change in LDL-C levels at 8 weeks. Secondary assessments included safety and tolerability, NCEP ATP III LDL-C goal achievement, change in other lipids and lipoproteins at 8 and 26 weeks, and health economics. Mean LDL-C levels were reduced significantly more with rosuvastatin 40 mg than with atorvastatin 80 mg at 8 weeks (-56% versus -52%, p<0.001). The proportion of patients achieving the NCEP ATP III LDL-C goal at 8 weeks was significantly higher in the rosuvastatin 40 mg group (80% versus 72%, p<0.01). Significant differences in the change from baseline in high-density lipoprotein cholesterol (HDL-C) (+9.6% versus +4.4%) and apolipoprotein (Apo)A-I levels (+4.2 versus -0.5) were observed between rosuvastatin and atorvastatin (all p<0.05). Both treatments were well tolerated. Based on a US analysis, rosuvastatin used fewer resources and delivered greater efficacy. Intensive lipid-lowering therapy with rosuvastatin 40 mg/day provided greater LDL-C-lowering efficacy than atorvastatin 80 mg/day, enabling more patients to achieve LDL-C goals. Rosuvastatin may therefore improve LDL-C goal achievement in high-risk patients with hypercholesterolemia.
北极星研究调查了40毫克瑞舒伐他汀和80毫克阿托伐他汀在高危高胆固醇血症患者中的疗效和安全性。患者(n = 871)被随机分为每日服用40毫克瑞舒伐他汀或每日服用80毫克阿托伐他汀,为期26周。主要终点是8周时低密度脂蛋白胆固醇(LDL-C)水平的百分比变化。次要评估包括安全性和耐受性、达到美国国家胆固醇教育计划成人治疗组第三次报告(NCEP ATP III)LDL-C目标的情况、8周和26周时其他脂质和脂蛋白的变化以及卫生经济学。在8周时,40毫克瑞舒伐他汀使LDL-C水平的降低幅度显著大于80毫克阿托伐他汀(-56%对-52%,p<0.001)。在40毫克瑞舒伐他汀组中,8周时达到NCEP ATP III LDL-C目标的患者比例显著更高(80%对72%,p<0.01)。瑞舒伐他汀和阿托伐他汀之间在高密度脂蛋白胆固醇(HDL-C)从基线的变化(+9.6%对+4.4%)和载脂蛋白(Apo)A-I水平(+4.2对- 0.5 )方面观察到显著差异(所有p<0.05)。两种治疗的耐受性都良好。基于美国的一项分析,瑞舒伐他汀使用的资源更少且疗效更佳。每日服用40毫克瑞舒伐他汀的强化降脂治疗比每日服用80毫克阿托伐他汀具有更强的降低LDL-C的疗效,使更多患者能够实现LDL-C目标。因此,瑞舒伐他汀可能会提高高危高胆固醇血症患者实现LDL-C目标的几率。 (注:原文中ApoA-I水平变化数据处“-0.5”疑似有误,可能影响整体理解,但按要求未做修改。)