Shuja Darab, Mian Muhammad Umar, Kaur Dhanjal Manpreet, Mengar Jaina, Butt Aqsa A, Chaudhari Sandipkumar S, Wei Calvin R, Khan Areeba
Internal Medicine, Services Hospital Lahore, Lahore, PAK.
Internal Medicine, Allama Iqbal Medical College, Lahore, PAK.
Cureus. 2024 Sep 4;16(9):e68602. doi: 10.7759/cureus.68602. eCollection 2024 Sep.
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.
急性冠状动脉综合征（ACS）仍然是全球发病和死亡的主要原因。他汀类药物，尤其是阿托伐他汀和瑞舒伐他汀，对于控制ACS患者的胆固醇水平和降低心血管风险至关重要。然而，这两种他汀类药物之间的直接对比研究有限。这项荟萃分析旨在比较阿托伐他汀和瑞舒伐他汀在降低ACS患者主要不良心血管事件（MACE）和全因死亡率方面的疗效。在PubMed、Embase、Cochrane图书馆和Scopus中进行了全面的文献检索，以查找截至2024年7月发表的研究。纳入了直接比较ACS患者中阿托伐他汀和瑞舒伐他汀的随机对照试验和观察性研究。主要结局是MACE的发生率和全因死亡率。六项涉及4195名患者的研究被纳入荟萃分析。汇总分析显示，阿托伐他汀和瑞舒伐他汀在降低MACE方面无统计学显著差异[风险比（RR）：0.91，95%置信区间（CI）：0.68至1.22，p值：0.54]或全因死亡率（RR：0.94，95%CI：0.52至1.70，p值：0.83）。研究之间未观察到显著异质性（两个结局的I²均为0%）。这项荟萃分析表明，阿托伐他汀和瑞舒伐他汀在降低ACS患者的MACE和全因死亡率方面具有相当的疗效。这些发现为临床医生根据个体患者因素在这些他汀类药物之间进行选择提供了灵活性。然而，需要进一步的大规模随机对照试验来证实这些结果，并探索特定患者亚组中的潜在差异。
