Atorvastatin vs rosuvastatin
Pro Research Analysisby 
Searched over 200M research papers
Efficacy in Lowering LDL Cholesterol and Lipid Profiles: Atorvastatin vs Rosuvastatin
Multiple studies consistently show that rosuvastatin is more effective than atorvastatin at lowering LDL cholesterol and improving overall lipid profiles. Rosuvastatin leads to greater reductions in LDL, total cholesterol, triglycerides, and atherogenic indices, and increases HDL more than atorvastatin in both diabetic and non-diabetic patients with dyslipidemia or cardiovascular disease 1368. This superior lipid-lowering effect is observed even when rosuvastatin is used at half the dose of atorvastatin .
Cardiovascular Outcomes and Event Prevention
When it comes to preventing major cardiovascular events (such as death, myocardial infarction, stroke, or revascularization), both statins show similar efficacy in large, long-term studies. In patients with coronary artery disease, the rates of these events over three years were nearly identical between rosuvastatin and atorvastatin . In acute ischemic stroke, rosuvastatin was associated with a slightly lower risk of recurrent stroke, myocardial infarction, and all-cause mortality at one year, but the difference was modest and may require further confirmation . For patients undergoing coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI), both statins performed similarly in preventing complications such as atrial fibrillation and contrast-induced nephropathy 17.
Inflammatory Markers and Cardiac Function
Rosuvastatin appears to have a stronger effect on reducing inflammatory biomarkers (such as hs-CRP, leptin, and sortilin) and improving left ventricular function in patients with type 2 diabetes and dyslipidemia, compared to atorvastatin. However, both statins are considered equally cardioprotective in these patients .
Safety and Side Effects
Both atorvastatin and rosuvastatin are generally well tolerated, with similar rates of most adverse events . However, rosuvastatin is associated with a higher risk of new-onset diabetes mellitus requiring antidiabetic medication and a higher incidence of cataract surgery compared to atorvastatin . Short-term studies show both statins can improve glucose homeostasis in prediabetic patients, but there is no significant difference between them in this regard .
Cost-Effectiveness and Practical Considerations
Cost-effectiveness analyses show mixed results. Atorvastatin is generally more cost-effective for acute coronary syndrome treatment, offering similar clinical benefits at a lower cost . In some long-term models, rosuvastatin is considered cost-effective in high-risk populations, especially in terms of quality-adjusted life years, but this depends on local healthcare costs and patient subgroups . Ultimately, the choice between the two may depend on cost, patient tolerance, and specific clinical scenarios 1210.
Conclusion
Rosuvastatin is more potent in lowering LDL cholesterol and improving lipid profiles, and may offer additional benefits in reducing inflammation. However, both rosuvastatin and atorvastatin are similarly effective in preventing major cardiovascular events. Rosuvastatin carries a higher risk of new-onset diabetes and cataract surgery, while atorvastatin is often more cost-effective. The choice between these statins should be individualized, considering patient-specific factors, cost, and risk profiles.
Sources and full results
Most relevant research papers on this topic