Evaluating long-term outcomes of rosuvastatin treatment to prevent heart complications

This study evaluated the long-term effects of rosuvastatin (Crestor) compared to placebo in reducing heart complications. This study concluded that rosuvastatin helped lower the risk of major cardiovascular events (MACE) in the long-term.

Most MACEs such as heart attack and stroke happen in people who do not have any signs of heart disease. Heart disease occurs when blood vessels in the heart narrow. Lifestyle changes such as a healthy diet, regular exercise, and reducing alcohol consumption can help lower the risk of heart disease. However, some patients may also need medication to lower their risk further.

Statins such as rosuvastatin are a type of medication used to lower cholesterol levels in the blood. Lowering cholesterol levels can help reduce the risk of high blood pressure, heart attacks, and strokes. It was shown previously that rosuvastatin reduces the risk of MACE over a medium-term (5.6 years). Whether rosuvastatin can help prevent MACE in patients without a history of heart disease in the long term is unclear.

This study included 9326 patients at medium risk for MACE. Patients were randomly assigned to receive either rosuvastatin (Group A) or a placebo (Group B). Some of the patients also received blood pressure-lowering medication. Patients received treatment for 5.6 years and were followed up for 3.1 years after the study ended. Patients were followed up for an average total of 8.7 years. During follow-up, both groups were evaluated for the risk of heart attack, stroke, heart failure, and mortality.

After the 3.1 years of follow-up, patients in Group A had a significant 20% lower risk of MACE than group B. There was also a 46% lower risk of heart events related to reduced blood flow to the heart after this period in group A compared to group B. During the full 8.7 follow-up period, patients in group A had a further reduction by 21% in the risk of MACE compared to placebo.

There was no benefit compared to placebo in patients who received blood pressure-lowering medication alone compared to placebo. However, after 3.1 years, patients who received both rosuvastatin and blood pressure medication had a 15% lower risk of MACE. The risk of events related to an inadequate blood supply to the heart (ischemia) significantly decreased by 54% compared to placebo. After the full 8.7 years, these risks further decreased by 24% (MACE) and 37% (ischemia).

This study concluded that rosuvastatin helped lower the risk of MACE such as heart attack and stroke compared to placebo. The authors suggest that while rosuvastatin did not help lower blood pressure, it did help reduce MACE in patients with high blood pressure.

AstraZeneca, the manufacturer of rosuvastatin, funded and provided the medication for this study. Also, the number of patients with high blood pressure was small, limiting some of these results. More studies are needed.

Discuss with your doctor if rosuvastatin is right for you.