One of the most commonly prescribed statins raises the risk of diabetes, warns a new study.
While two of the most widely used of cholesterol-lowering drugs are effective in reducing the risk of a heart attack or stroke, researchers found that rosuvastatin increases the risk of type 2 diabetes.
The findings, published by The BMJ, show that rosuvastatin and atorvastatin are “equally effective” at preventing heart attacks, strokes and death in people with coronary artery disease.
But while taking rosuvastatin, provided under the brand name Crestor among others, is associated with lower cholesterol levels, scientists say it also carries a higher risk of developing diabetes than atorvastatin.
Lowering levels of LDL cholesterol – also known as “bad” cholesterol – with statins is recommended for people with coronary artery disease – when the blood vessels supplying the heart are narrowed or blocked.
However, few previous trials have directly compared the long-term clinical effects of the two most potent statins – rosuvastatin and atorvastatin – in coronary artery disease patients.
Statins are one of the most commonly prescribed drugs in the UK with an estimated seven to eight million adults in the UK taking them. More than 71 million prescription items were dispensed in 2018 alone, according to the British Heart Foundation (BHF).
Researchers analyzed the results of the LODESTAR clinical trial, involving 4,400 adults, with an average age of 65, with coronary artery disease at 12 hospitals in South Korea.
At the start of the trial, medical history and lifestyle information were recorded and participants were randomly assigned to receive either daily rosuvastatin or atorvastatin for three years from September 2016 to November 2019.
The Korean research team then examined differences between the two groups in terms of deaths from any cause and rates of heart attacks, strokes, and coronary revascularization – procedures to restore blood flow to parts of the heart.
Several other health indicators – including the development of type 2 diabetes, hospital admissions due to heart failure, major blood clots, and cataract surgery – were also assessed.
In all, 4,341 of the 4,400 participants (98.7 percent) completed the trial.
The research team found no “discernible” differences between the two groups for all causes of death, heart attack – also known as myocardial infarction, stroke or any revascularization.
The average LDL cholesterol level during the study period was slightly lower in the rosuvastatin group than the atorvastatin group, according to the findings.
However, the rosuvastatin group had a higher rate of developing type 2 diabetes requiring medication (7.2 percent) compared to the atorvastatin group (5.3 percent).
The rosuvastatin group also had a higher rate of needing cataract surgery (2.5 percent) than the atorvastatin group (1.5 percent).
However, other safety outcomes did not differ between the two groups.
The research team acknowledged limitations to the study, including the fact that only Asian participants were included in the trial, and the three-year study period may have been relatively short to find the longer-term effects of two statin types.
But they say their findings “should be interpreted with caution, and further dedicated investigation with longer follow-up is warranted.”
Study author Professor Myeong-Ki Hong, of Yonsei University College of Medicine, said: “In people with coronary artery disease, rosuvastatin and atorvastatin showed comparable efficacy in terms of a composite of all-cause death, myocardial infarction, stroke, or any coronary revascularisation within three years.”
He added: “Rosuvastatin was associated with lower LDL cholesterol levels, but it incurred a higher risk of new-onset diabetes mellitus requiring antidiabetics and cataract surgery than atorvastatin.”
Produced in association with SWNS Talker