Patients with acute coronary syndrome are recommended for early aggressive low-density
lipoprotein (LDL) cholesterol–lowering therapy. The LUNAR study compared the efficacy
of rosuvastatin with that of atorvastatin in decreasing LDL cholesterol in patients
with acute coronary syndrome. Adult patients with coronary artery disease who were
hospitalized for an acute coronary syndrome within 48 hours of first symptoms were
randomized (n = 825) to an open-label, once-daily treatment with rosuvastatin 20 mg
(RSV20), rosuvastatin 40 mg (RSV40), or atorvastatin 80 mg (ATV80) for 12 weeks. Patients
were evaluated at weeks 2, 6, and 12. The primary end point was treatment efficacy
in lowering LDL cholesterol averaged over 6 to 12 weeks. Changes in other lipoproteins,
including high-density lipoprotein (HDL) cholesterol, and safety were evaluated. Analysis
of covariance was used to compare least squares mean differences between each rosuvastatin
treatment arm and the atorvastatin arm. The efficacy of RSV40 in lowering LDL cholesterol
was significantly greater than that of ATV80 (46.8% vs 42.7% decrease, p = 0.02).
LDL cholesterol lowering by RSV20 was similar to that by ATV80. Increases in HDL cholesterol
were significantly greater with RSV40 (11.9%, p <0.001) and RSV20 (9.7%, p <0.01)
than with ATV80 (5.6%). RSV40 was also significantly more effective than ATV80 in
improving most other secondary efficacy variables, whereas the effects of RSV20 on
these parameters were generally similar to those of ATV80. All 3 treatments were generally
well tolerated over 12 weeks. In conclusion, results from the LUNAR study show that
RSV40 more effectively decreased LDL cholesterol, increased HDL cholesterol, and improved
other blood lipid parameters than ATV80 in patients with acute coronary syndrome.
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Article info
Publication history
Published online: February 23, 2012
Accepted:
December 15,
2011
Received in revised form:
December 15,
2011
Received:
November 7,
2011
Footnotes
The LUNAR Trial was funded by AstraZeneca LP, Wilmington, Delaware. Dr. Pitt had served as a consultant to AstraZeneca, Wilmington, Delaware; Merck, Whitehouse Station, New Jersey; Novartis, East Hanover, New Jersey; Pfizer, New York, New York; Bayer, Pittsburgh, Pennsylvania; Boehringer Ingelheim, Ridgefield, Connecticut; Forest Laboratories, New York, New York; and Takeda, Deerfield, Illinois. Dr. Loscalzo has served on the Scientific Advisory Committee of the LUNAR Trial as a paid consultant.
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Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
