他汀类药物治疗心房颤动随机对照试验的Meta分析

目的评价他汀类药物抗心房颤动（房颤）的疗效。方法采用Cochrane系统评价的方法,计算机检索PubMed、EMbase、EMB Reviews—Cochrane Central Register of Controlled Trials（2007年第3期）、中国生物医学文献数据库、中文科技期刊数据库,中国期刊全文数据库,检索时间截至2007年9月15日,纳入中外文他汀类药物抗房颤的随机对照试验（RCTo由两名评价者独立评价纳入研究质量、提取资料并交叉核对。采用RevMan4．3软件进行Meta分析。结果共纳入5个RCT,包括470例房颤患者。各研究间存在统计学异质性（I^2=66．8％,P=0．02）,故采用随机效应模型进行合并分析,其结果显示,他汀类药物可减少房颤复发,发生率[RR=0．61,95％CI（0．43,0．88）,P=0．008o敏感性分析显示结果稳定性较好,失安全数为52．91。结论他汀类药物可以有效降低房颤的复发和发生率。但本研究中部分文献质量不高,加之有关他汀类药物预防房颤的RCT文献数量较少,总样本量较小,上述结论尚有待开展大样本、随机、双盲对照试验证实。     

他汀类药物治疗成人骨质疏松的系统评价

目的系统评价他汀类药物治疗成人骨质疏松的疗效和安全性。方法计算机检索Cochrane图书馆（2007年第4期）、Cochrane图书馆临床对照试验资料库（2007年第4期）、MEDLINE（1990～2007．11）、EMbase（1990～2007．11）、Current Controlled Trials、The National Research Register、中国生物医学文献数据库（1990—2007．11）、中文科技期刊全文数据库（1990—2007．11）、中文学术期刊全文数据库（1990—2007．11）.手工检索《中国骨伤》、《中国骨科杂志》以及相关的中英文会议论文集。纳入他汀类药物治疗成人骨质疏松的随机对照试验，并对纳入研究进行质量评价。结果纳入2篇随机对照研究，由于临床异质性无法进行Meta分析。2项研究结果基本一致，他汀类药物对增加腰椎、髋部的骨密度及改善骨代谢指标无明显作用，但辛伐他汀可以增加前臂的骨密度。结论目前证据不支持他汀类药物可以增加腰椎、髋部的骨密度，改善骨代谢指标，不推荐他汀类药物用于治疗成人骨质疏松症。需进一步开展大样本、多中心随机、双盲、安慰剂对照试验来确定他汀类药物治疗骨质疏松的疗效。     

他汀类药物对脑梗死患者C-反应蛋白和颈动脉内中膜厚度影响的系统评价

目的系统评价他汀类药物对脑梗死患者C-反应蛋白（C-reactive protein,CRP）的影响及其临床意义,探讨CRP是否可作为他汀类药物预防卒中再发的疗效指标。方法计算机检索PubMed、EMBASE、Cochrane图书馆临床对照试验资料库、CBMdisc和CNKI等数据库,检索时间均从建库至2008年8月,收集他汀类药物对脑梗死患者CRP影响的随机对照试验（RCT）,对符合纳入标准的临床研究进行质量评价和资料提取后,采用RevMan5．0软件进行Meta分析。结果共纳入23个RCT,包括1946例患者。Meta分析结果显示：①对CRP的影响：共纳入20个研究（1664例患者）,与空白对照组相比,他汀治疗能显著降低患者血浆CRP[WMD=-5．79,95％CI（-7．32,-4．26）]。2个研究（82例患者）表明,与辛伐他汀组比较,阿托伐他汀组CRP下降幅度更大[WMD=-1．78,95％CI（-3．92,0．36）]。②对颈动脉内中膜厚度的影响：纳入4个研究（446例患者）,他汀治疗能显著减少内中膜厚度[WMD=-0．21,95％CI（-0．25,-0．17）]。③神经功能缺损改善情况：2个研究（206例患者）表明,与对照组比较,他汀组神经功能缺损改善情况优于对照组[OR=2．22,95％CI（0．94,5．21）].结论现有的临床研究证据显示,与对照组比较,他汀类药物能显著降低脑梗死患者的CRP,减少颈动脉内中膜厚度。他汀类降低CRP的作用和神经功能缺损的改善及预后的相关性尚需要进一步的临床研究。     

他汀类药物对造影剂肾病预防效果的荟萃分析

目的系统评价他汀类药物对造影剂肾病的预防效果。方法检索1990年1月至2009年12月Cochrane图书馆、Medline数据库和EMBASE数据库,并鉴定随机对照研究的质量,按Jadad质量评分进行评定,用RevMan4.2软件进行荟萃分析。结果初步检索共有116篇相关文献,有8篇文献入选,8项研究共纳入32206例患者,6项研究的Jadad评分超过3分。荟萃分析的结果显示,他汀类药物的应用能够预防造影剂肾病(contrast induced nephropathy,CIN)的发生(OR=0.72,95%CI0.67～0.78,P0.05);在水化的基础上应用他汀类药物与单纯水化相比,不能减少CIN的发生(OR=0.72,95%CI0.61～1.01,P=0.06)。结论他汀类药物对CIN发生有显著的预防效果。在水化基础上应用他汀类药物并不比单纯水化更加有效。     

他汀类降脂药物对伴或不伴急性冠状动脉综合征CIN患者影响Meta分析

目的系统评价他汀类降脂药物对伴或不伴急性冠状动脉综合征患者造影剂相关肾功能损害的疗效。方法检索Science Direct、PubMed、EMbase、Cochrane图书馆、CNKI、WanFang Dat、CBM数据库,收集他汀类降脂药物与造影剂肾病相关的随机对照试验(RCT),检索时限均为建库至2019年12月。由2名研究员独立筛选文献、提取数据,以造影剂肾病的发病率、造影后血肌酐水平、造影后估.算的肾小球滤过率为结局指标,采用RevMan5.0软件进行Meta分析。结果共计7个RCT符合纳入标准,包含行血管造影患者1986例,与对照组比较,他汀类药物可显著减少造影剂肾病的发生率[RR=0.45,95%CI:(0.32,0.64),P<0.001],造影后血肌酐水平变化[MD=-0.12,95%CI:(-0.12,-0.01),P=0.02]有统计学意义,造影后估算的肾小球滤过率[MD=4.67,95%CI:(-2.83,12.17),P=0.22]无统计学意义。结论他汀类药物在一定程度上能够预防造影剂相关肾损害,且只针对伴有急性冠状动脉综合征患者。     

血脂康与他汀类药物调脂效果对比及安全性分析

目的评价血脂康与常见他汀类降脂药物对原发性高脂血症疗效。方法计算机检索Pub Med、Cochrane图书馆、万方医学数据库、维普中文科技期刊全文数据库,筛选关于中药血脂康与他汀类药物治疗原发性高脂血症随机对照实验。评价指标包括胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。采用Revman5.3软件进行分析。结果实验共纳入14篇文献,共计1150例患者,结果血脂康、他汀类药物均明显降低原发性高脂血症患者TC、TG、LDL-C,明显升高HDL-C,但Meta分析提示血脂康与他汀类药物对原发性高脂血症患者降低血TC、TG、LDL-C疗效差异无统计学意义[WMD=0.01mmol/L,95%CI:(-0.05~0.07)mmol/L,P0.05;WMD=0.07 mmol/L,95%CI:(-0.26~0.41)mmol/L,P0.05;WMD=0.13 mmol/L,95%CI:(-0.44~0.69)mmol/L,P0.05],对升高患者血高密度脂蛋白疗效差异无统计学意义[WMD=0.13 mmol/L,95%CI:(-0.44~0.69)mmol/L,P0.05]。结论血脂康与他汀类药物均可降低原发性高脂血症患者血TC、TG、LDL-C,升高血HDL-C,两者疗效相当,血脂康致不良反应更少,安全性更高。     

经皮冠状动脉介入术前他汀治疗预防围手术期患者心肌梗死效果的Meta分析

目的 系统评价经皮冠状动脉介入术(PCI)术前使用他汀治疗预防围手术期冠心病患者心肌梗死的有效性.方法 计算机检索CNKI、CBM、MEDLINE和The Cochrane Library,收集PCI术前他汀治疗对心血管事件影响的随机对照试验,检索时限均从1990年1月至2011年5月.由2位评价者按照纳入和排除标准筛选文献、提取资料并进行方法学质量评价,然后采用RevMan 5.0软件进行Meta分析.结果 最终纳入10个随机对照试验,共3 012例冠心病患者.Meta分析结果显示:在围手术期,对照组1 498例中有207例发生心肌梗死,他汀治疗组1514例中有98例发生心肌梗死,两组差异有统计学意义[ OR=0.43,95％ CI (0.34,0.56),P＜0.000 01];对照组有226例发生主要心脏不良事件,他汀治疗组103例发生主要心脏不良事件,两组差异有统计学意义[OR=0.41,95％CI (0.32,0.53),P＜ 0.000 01].结论 与安慰剂治疗相比,PCI术前应用他汀类药物可明显降低围手术期冠心病患者心肌梗死发生率和主要心脏不良事件.受纳入研究数量和质量所限,上述结论尚需开展更多高质量大样本研究验证.     

瑞舒伐他汀降压作用的meta分析

目的 评价瑞舒伐他汀联合降压药物对高血压合并血脂异常患者的降压疗效及安全性。方法 计算机检索PubMed、WOS核心合集(含SCIE、SSCI、A&HCI、CPCI数据库)、The Cochrane Library、中国知网、万方数据库、维普网,检索时限均为建库至2022年11月,收集瑞舒伐他汀联合降压药物与单独降压药物治疗高血压合并血脂异常患者的随机对照试验,由2位研究者按纳入和排除标准独立筛选文献、提取资料、交叉核对并进行方法学质量评估后,采用用STATA12.0软件进行Meta分析。结果 共纳入11项随机对照研究,共1275例患者,其中试验组(瑞舒伐他汀联合降压药物)696例,对照组(单独降压药物)579例。Meta分析结果显示：试验组血压下降幅度大于对照组(收缩压：WMD=-1.97,95%CI:-3.55～0.38,P=0.02;舒张压：WMD=-1.24,95%CI:-2.20～-0.29,P=0.01);其中亚组分析显示,瑞舒伐他汀与两类降压药物(氨氯地平+沙坦类降压药)三联用药的降压效果更显著(收缩压：WMD=-4.06,95%CI:-6.84～-1.29,P=...     

经皮冠状动脉介入治疗前应用他汀类药物患者围手术期心肌损伤的meta分析

目的 客观评价经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)前他汀类药物治疗对围手术期心肌梗死、术后肌酸激酶同工酶(creatine kinase-MB,CK-MB)和肌钙蛋白(troponin)升高的影响.方法 检索PUBMED、EMCC、Highwire数据库及Cochrane图书馆等数据库.检索策略为:(percutaneous coronary intervention,OR PCI) AND (statin OR statins OR hydroxymethylglutaryl-CoA) AND (randomized trial).入选试验满足条件:随机对照试验,PCI术前应用他汀类药物,试验组为服用他汀类药物的患者,对照组为服用安慰剂、未服用他汀类药物或者服用非大剂量他汀类药物的患者,以围手术期心肌梗死或者CK-MB、肌钙蛋白升高发生率为研究结局.采用比值比(OR)和95%可信区间(CI) 作为结果分析的统计量.应用RevMan 5.0以及SAS 9.2软件进行统计分析.结果 ①术前应用他汀类药物与未应用他汀类药物对比:与未应用他汀类药物比较,PCI术前应用他汀类药物治疗可以降低围手术期心肌梗死的发生率(OR=0.44,95%CI=0.34~0.57,P＜0.01),术后CK-MB升高的发生率(OR=0.50,95%CI=0.40~0.62,P＜0.01)以及肌钙蛋白升高的发生率(OR=0.65,95%CI=0.49~0.86,P<0.01).进一步分析发现:只有PCI术前应用大剂量他汀类药物才可以减少围手术期心肌梗死(OR=0.41,95%CI=0.30~0.55,P＜0.01),术后CK-MB升高(OR=0.43,95%CI=0.33~0.56,P＜0.01)以及肌钙蛋白升高的发生率(OR=0.57,95%CI=0.46~0.70,P＜0.01);而非大剂量他汀类药物不能降低围手术期心肌梗死(OR=0.58,95%CI=0.34~0.99,P=0.05)、术后CK-MB升高(OR=0.75,95%CI=0.49~1.14,P>0.05)以及肌钙蛋白升高的发生率(OR=0.91,95%CI=0.66~1.26,P>0.05).②术前应用大剂量他汀类药物与应用非大剂量他汀类药物对比:与应用非大剂量他汀类药物对比,PCI术前应用大剂量他汀可以降低围手术期心肌梗死的发生率(OR=0.40,95%CI=0.20~0.79,P<0.01),术后CK-MB升高的发生率(OR=0.46,95%CI=0.27~0.76,P<0.01)以及肌钙蛋白升高的发生率(OR=0.58,95%CI=0.38~0.88,P=0.01).结论 PCI术前只有给予大剂量的他汀类药物治疗才可以降低围手术期心肌梗死、以及术后CK-MB和肌钙蛋白升高的发生率.     

中国人群载脂蛋白E基因多态性与他汀类药物疗效关系的Meta分析

目的：评价中国人群载脂蛋白 E(APOE)基因多态性对他汀类药物降脂疗效的影响。方法在数据库中检索,获取 APOE 基因多态性与他汀类药物疗效关系的文献,筛选并对纳入文献进行质量评分和数据提取,使用RevMan 5.3软件进行 Meta 分析。结果ε2等位基因携带者低密度脂蛋白胆固醇(LDL-C)降低水平显著大于ε3ε3基因型(高脂血症组 P <0.05;阿托伐他汀组 P <0.01)和ε4等位基因(冠心病组 P =0.01;阿托伐他汀组 P =0.01)。ε2等位基因总胆固醇(TC)降低水平显著大于ε3ε3基因型(高脂血症组 P <0.01)和ε4等位基因(高脂血症组 P <0.01;冠心病组 P =0.02;阿托伐他汀组 P <0.01)。ε3ε3基因型甘油三酯(TG)降低水平显著大于ε4等位基因(总体 P <0.01;高脂血症组 P =0.03;辛伐他汀组 P =0.03)。ε2等位基因高密度脂蛋白胆固醇(HDL-C)升高水平显著大于ε3ε3基因型(高脂血症组 P =0.02)。结论 APOE 基因多态性与他汀类药物疗效相关,ε2等位基因携带者具有更好的降脂效果。     

他汀类药物治疗阿尔茨海默病的Meta分析

目的:系统评价他汀类药物治疗阿尔茨海默病(AD)的疗效。方法:通过计算机检索,全面收集他汀类药物治疗AD的随机对照试验,按Cochrane协作网系统评价的方法进行评价。结果:入选4项研究,共纳入1127例患者,其中他汀类药物组557例,安慰剂组570例。2组的AD评定量表-认知分量表(ADAS-Cog)评分与基线变化的比较,合并平均差(MD)为0.97,95%CI为(-0.84,2.78),简易精神状态量表(MMSE)评分与基线变化的比较,MD为0.88,95%CI为(-0.28,2.04),日常生活能力量表(ADL)评分与基线变化的比较,MD为-0.85,95%CI为(-3.50,1.80),神经精神症状问卷(NPI)评分与基线变化的比较,MD为-1.41,95%CI为(-3.47,0.65),差异均无统计学意义。结论:目前没有足够证据推荐他汀类药物用于治疗AD。     

Statins and Cognition: A Systematic Review and Meta-analysis of Short- and Long-term Cognitive Effects

ObjectiveTo evaluate the effect of statins on short-term cognitive function and the long-term incidence of dementia.Patients and MethodsA systematic search was performed of MEDLINE, EMBASE, and the Cochrane Central Register from their inception to April 25, 2013. Adults with no history of cognitive dysfunction treated with statins were included from high-quality randomized controlled trials and prospective cohort studies after formal bias assessment.ResultsSixteen studies were included in qualitative synthesis and 11 in quantitative synthesis. Short-term trials did not show a consistent effect of statin therapy on cognitive end points. Digit Symbol Substitution Testing (a well-validated measure of cognitive function) was the most common short-term end point, with no significant differences in the mean change from baseline to follow-up between the statin and placebo groups (mean change, 1.65; 95% CI, –0.03 to 3.32; 296 total exposures in 3 trials). Long-term cognition studies included 23,443 patients with a mean exposure duration of 3 to 24.9 years. Three studies found no association between statin use and incident dementia, and 5 found a favorable effect. Pooled results revealed a 29% reduction in incident dementia in statin-treated patients (hazard ratio, 0.71; 95% CI, 0.61-0.82).ConclusionIn patients without baseline cognitive dysfunction, short-term data are most compatible with no adverse effect of statins on cognition, and long-term data may support a beneficial role for statins in the prevention of dementia.     

Potential nontraditional applications of statins

OBJECTIVE: To review the current evidence for use of hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) in nontraditional lipid-related applications, including acute coronary syndromes, peripheral arterial disease, stroke, and renal disease, and to describe ongoing trials evaluating the role of statins in these conditions. DATA SOURCES: Clinical literature was identified by a MEDLINE search (1990-November 2002) using >/=1 of the following search terms: acute coronary syndrome(s), angina pectoris, atherosclerosis, atorvastatin, clinical trials, diabetes mellitus, end-stage renal disease, fluvastatin, lovastatin, myocardial infarction, peripheral arterial disease, pravastatin, simvastatin, statins, and stroke. Treatment guidelines issued by professional and governmental organizations, such as the American Diabetes Association, American Heart Association, National Cholesterol Education Program, National Kidney Foundation, and National Stroke Foundation, were reviewed. STUDY SELECTION AND DATA EXTRACTION: Articles identified from the data sources were included if they pertained to the conditions described in the objectives and provided unique information concerning use of statins. DATA SYNTHESIS: Substantial evidence exists for the use of statins in acute coronary syndromes. Meta-analyses of data from major clinical trials indicate that statins prevent first and recurrent stroke, and large-scale trials are underway to evaluate the efficacy of statins in this setting. Accumulating evidence suggests that statins may be beneficial in reducing the morbidity and mortality associated with peripheral arterial disease and end-stage renal disease, and results from ongoing trials may confirm these benefits. Statins may also have a future role in amelioration of other conditions associated with atherosclerosis, such as diabetes mellitus. CONCLUSIONS: A large body of evidence supports the evaluation of statins in clinical settings beyond primary and secondary prevention of morbidity and mortality associated with coronary atherosclerosis.     

HMG-CoA reductase inhibitors for the prevention of nephropathy

OBJECTIVE: To evaluate the literature to determine whether hydroxymethylglutaryl coenzyme A reductase inhibitors are effective for the prevention of nephropathy. DATA SOURCES: MEDLINE (1966-April 2003) and International Pharmaceutical Abstracts(1970-April 2003), as well as bibliographic searches, were conducted. DATA SYNTHESIS: Although the statins are widely used for the prevention of coronary heart disease, non-lipid-lowering effects are also being investigated, namely their potential role in the prevention of nephropathy. Five trials of the statins used in this manner are reviewed, most of which included patients with dyslipidemias, making it difficult to determine whether the renoprotective effects were independent of the lipid-lowering effects. CONCLUSIONS: Adequate evidence does not currently exist to support the widespread use of statins as alternatives to strategies known to prevent the progression of renal disease, but statins may be used to complement other therapies in patients with additional indications.     

Lack of effect of statins on maintenance of normal sinus rhythm following electrical cardioversion of persistent atrial fibrillation

Randomised controlled trials evaluating the effect of statin use on maintenance of normal sinus rhythm (NSR) after electrical cardioversion (ECV) of persistent atrial fibrillation (AF) have demonstrated conflicting results. However, many of these trials were of relatively small size and thus underpowered to adequately evaluate this end‐point. The aim of this study was to conduct a meta analysis evaluating the effect of statin use on maintenance of NSR after ECV of persistent AF. Randomised controlled trials evaluating the use of statins to maintain NSR after ECV of AF were identified through a systematic search including Medline (1950 through December 2009), the Cochrane CENTRAL Register (4th quarter, 2009) and a manual review of references without any language restrictions. Pooled estimates of effect are reported as relative risks (RRs) with accompanying 95% confidence intervals (CIs) using a random‐effects model. Four trials (n = 424; range: 48–212) were identified and subject to meta analysis. Evaluated statins included atorvastatin 10 and 80 mg and pravastatin 40 mg/day. Over a mean of 2.1 months (range: 1–3 months) statins did not increase the likelihood of maintaining NSR following ECV (RR, 1.12; 95%CI, 0.85–1.46) compared with control. Current evidence does not suggest that statins are associated with an increased probability of maintaining NSR following ECV of persistent AF.     

A systematic review and meta‐analysis on the therapeutic equivalence of statins

Background: Statins are the most commonly prescribed agents for hypercholesterolemia because of their efficacy and tolerability. As the number of patients in need of statin therapy continues to increase, information regarding the relative efficacy and safety of statins is required for decision‐making. Objective: This study will use systematic review to compare the efficacy and safety profiles of different statins at different doses and determine the therapeutically equivalent doses of statins to achieve a specific level of low‐density lipoprotein cholesterol (LDL‐C) lowering effect. Methods: Publications of head‐to‐head randomized controlled trials (RCTs) of statins were retrieved from the Oregon state database (1966–2004), MEDLINE (2005‐April of 2006), EMBASE (2005‐April of 2006), and the Cochrane Controlled Trials Registry (up to the first quarter of 2006). The publications were evaluated with predetermined criteria by a reviewer before they were included in the review. The mean change in cholesterol level of each statin was calculated and weighted by number of subjects involved in each RCT. Where possible, meta‐analysis was performed to generate pooled estimates of the cholesterol lowering effect of statins and the difference between statins. Results: Seventy‐five studies reporting RCTs of head‐to‐head comparisons on statins were included. Most studies had similar baseline characteristics, except the rosuvastatin related studies. A daily dose of atorvastatin 10 mg, fluvastatin 80 mg, lovastatin 40–80 mg, and simvastatin 20 mg could decrease LDL‐C by 30–40%, and fluvastatin 40 mg, lovastatin 10–20 mg, pravastatin 20–40 mg, and simvastatin 10 mg could decrease LDL‐C by 20–30%. The only two statins that could reduce LDL‐C more than 40% were rosuvastatin and atorvastatin at a daily dose of 20 mg or higher. Meta‐analysis indicated a statistically significant but clinically minor difference (<7%) between statins in cholesterol lowering effect. Comparisons of coronary heart disease prevention and safety could not be made because of insufficient data. Conclusions: At comparable doses, statins are therapeutically equivalent in reducing LDL‐C.     

Therapeutic effect of statin on aortic stenosis: a review with meta‐analysis

Background: Aortic stenosis (AS) is a common progressive disease. Statins have been hypothesized to delay its progression via pleiotropic mechanisms. However, results of clinical trials focusing on statin therapy in AS patients have been controversial. Objective: To analyse and summarize the findings in recent statin trials and to discuss the rationale of statin usage in AS populations. Methods: A comprehensive database search was conducted by two independent reviewers. Controlled trials that compared progression of AS between statin and non‐statin therapy published before 31 December 2008 were included. Data were extracted for meta‐analysis, to estimate overall effects, if available. Factors that contributed to heterogeneities among the trials were analysed. Results: The meta‐analysis included nine trials with a total of 2947 patients. Statin therapy displayed an overall statistically significant effect on delaying AS progression. The weighted mean difference (statin vs. control) of annual increase of peak aortic‐jet velocity was ?0·12 m/s (95% confidence interval ?0·22 to ?0·03); the increase of mean transaortic pressure gradient was ?1·64 mmHg per year (?3·27 to ?0·01); Heterogeneity‐analysis suggested that the baseline risk factors and characteristics of the patients, the use of different statins, and the time point to initiate statin therapy, may be important considerations when interpreting the result of individual studies. Conclusion: Although the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) trial reported negative results in delaying AS progression in low‐risk patients, the potential benefits of statins in those with multiple risk factors and their value in preventing future coronary events call for further investigation of different categories of AS patients.     

Approximate equivalent rosuvastatin doses for temporary statin interchange programs

OBJECTIVE: To estimate approximate doses of rosuvastatin equivalent to the other hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) for a temporary substitution program. DATA SOURCES: A literature search was conducted to locate clinical trials directly comparing rosuvastatin with other statins that evaluated the magnitude of cholesterol lowering. DATA SYNTHESIS: The mean low-density lipoprotein and total cholesterol values from the clinical trials were assessed. Study results indicate that rosuvastatin is not equivalent to other statins on a milligram-to-milligram basis. CONCLUSIONS: Rosuvastatin appears to be at least 2 and 4 times as potent as atorvastatin and simvastatin, respectively, and at least 8 times as potent as pravastatin and lovastatin.