Effects Of Atorvastatin And Pitavastatin On Lipids,Regression Of Atherosclerosis Via Intravascular Ultrasound(IVUS) And HbA1c:A Meta-analysis

1 BackgroundAtherosclerosis Cardio-Vascular disease,the most prevalent disease,has become the leading cause of morbidity and mortality all over the world.Statins,which competitively inhibit the activity of HMG-CoA reductase,can efficiently reduce cholesterol synthesis in the liver,regarding as the corner stone for primary prevention and secondary prevention of cardiovascular disease.It's generally accepted that statins could result in reduction of plasma LDL-C concentration,increment in plasma HDL-C concentration,improvement of endothelial function,attenuation of vascular/myocardial remodeling as well as stabilization of atherosclerotic plaque.Atorvastatin and pitavastatin,nowadays,considered as the most frequently prescribed statins in clinical practice,could effectively reduce plasma concentration of LDL-C.However,several studies have shown inconsistent finding for the efficacy and safety of atorvastatin and pitavastatin on lipids metabolism.The aim of present study is to compare the efficacy and safety of atorvastatin and pitavastatin using data from RCT pooled together by means of a meta-analysis,and decide which is better.2 Methods and Results:PubMed,CENTRAL,Web of Knowledge,and ClinicalTrials.gov website were searched for randomized controlled trials published until October-2016.Eligible studies comparing atorvastatin and pitavastatin head-to-head and reporting the outcome of LDL-C,HDL-C,HbA1c and IVUS evaluation were enrolled.Heterogeneity was assessed by using the I2 statistic,and the extracted data were estimated by fixed-effects model.11 trials including a total number of 1733 participants were identified.Compared with atorvastatin,changes in the MD of LDL-C and HDL-C were 2.51(95%CI:1.17,3.86;I2 =48%;P=0.0003)and 2.17(95%CI:1.42,2.91;I2=40%;P<0.00001)for pitavastatin respectively.The changes in the MD of HbAcl were-0.15(95%CI:-1.44,1.15;I2=0%;P=0.83)for pitavastatin compared with atorvastatin.For PV,LV and EEM,the changes are-0.93(95%CI:-3.04,1.19;I2 =50%;P=0.39),0.17(95%CI:-2.91,3.26;I2=0%;P=0.91)and-0.43(95%CI:-1.96,1.11;I2 =4%;P=0.58)repectively for pitavastatin VS.atorvastatin.3 ConclusionsIn the present study,pitavastatin seems to be less effective in reducing LDL-C and HDL-C level compared with atorvastatin.And there is no significant difference in changes of IVUS evaluation and HbAcl evaluation between pitavastatin and atorvastatin.