Rosuvastatin more effective than atorvastatin in ACS

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The lipid-modifying effects of rosuvastatin are stronger than atorvastatin in patients with acute coronary syndrome (ACS), according to new data from the LUNAR trial published in the American Journal of Cardiology in February this year. The LUNAR trial involved 825 adults with coronary artery disease who were hospitalized for ACS within 48 hours of first symptoms. They were randomly assigned to once-daily rosuvastatin 20 or 40 mg or atorvastatin 80 mg for 12 weeks.

Rosuvastatin 40 mg was significantly more effective at lowering LDL cholesterol compared to atorvastatin 80 mg (with decreases of 46.8% vs 42.7%; p=0.02). Efficacy was similar with rosuvastatin 20 mg and atorvastatin 80 mg.

Increases in HDL cholesterol were also significantly greater with rosuvastatin 40 mg (11.9%; p<0.001) and rosuvastatin 20 mg (9.7%; p<0.01) than with atorvastatin 80 mg (5.6%).

Still, the finding that rosuvastatin 20 mg was as effective as atorvastatin 80 mg in decreasing LDL cholesterol with a similar safety profile suggests that this dose of rosuvastatin might be considered an alternative to atorvastatin 80 mg in patients with ACS. [HeartWire]

BP mismatch between arms signals risk

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Patients with hypertension who have more than 10 mmHg digit differences in blood pressure between arms appear to be at risk for cardiovascular events and premature death.

The risk of all-cause death over a follow-up of about 10 years was more than three-fold higher for patients with inter arm systolic blood pressure differences of 10 mm Hg and 15 mm Hg according to Christopher Clark, PhD, of the University of Exeter in England, and colleagues. Similar relationships were seen for cardiovascular death and combined cardiovascular and cerebrovascular events, the researchers reported online in BMJ.

The findings are consistent with a meta-analysis published by Clark’s group in January, which showed that the same interarm differences were associated with peripheral vascular disease, as well as cardiovascular and all-cause death.

Bilateral blood pressure measurements should become a routine part of cardiovascular assessment in primary care.

Authors examined data from 230 patients treated for hypertension. One in five had pre-existing ischemic heart disease or peripheral vascular disease. At baseline, 24% of the patients had an interarm difference in systolic blood pressure of 10 mm Hg or more and 9% had a difference of at least 15 mm Hg. During 9 years follow-up, 44% of the patients had a cardiovascular or cerebrovascular event, or died. [MedPage]