Meta-anajysis Comparing Effects Of Rosuvastatin And Atorvastatin On Plaque Volume Measured By Intravascular Ultrasound

Background:Recent studies have shown inconsistent results on the effect of rosuvastatin and atorvastatin on plaque volume measured by intravascular ultrasound (IVUS). The aim of this meta-analysis was to investigate the effects of these2statins on total atheroma volume (TAV) and percent atheroma volume (PAV) respectively, and determine which is better.Methods and Results:PubMed was searched for relevant randomized controlled trials. Eligible studies reported TAV and PAV during treatment with atorvastatin compared with control (usual care), or rosuvastatin with atorvastatin head to head. We used the I2statistic to assess the statistical heterogeneity and pooled results using the random-effect model. Eight trials with1864participants were analyzed in this meta-analysis. The changes in the mean difference (MD) of TAV and PAV from baseline were-1.59(95%confidence interval [CI]:-3.05—0.14) and-0.36(95%CI:-0.70—0.02) in the head-to-head comparison. Compared with control, change in the MD of TAV was-6.65(95%CI:-10.98—2.32) for atorvastatin. The MD of low-density lipoprotein cholesterol(LDL-C) changes from baseline and follow-up LDL-C were-6.65(95%CI:-11.23—2.08) and-6.36(95%CI:-9.51—3.20) in the head-to-head comparison,-47.03(95%CI:-54.71—39.35) and-47.37(95%CI:-57.39—37.35)for atorvastatin vs. the control group, the relative risk (RR) of major cardiovascular events was1.08(95%CI:0.79-1.47) for the head-to-head comparison and0.70(95%CI:0.34-1.46) for atorvastatin compare with control (usual care). Conclusions:Atorvastatin decreases plaque volume, and rosuvastatin is more effective compared with atorvastatin. On the basis of plaque regression, atorvastatin can’t improve the incidence of major cardiovascular events, also rosuvastatin shows no advantage compared with atorvastatin.