A rapid (differential) effect of rosuvastatin and atorvastatin on high-sensitivity cardiac Troponin-I in subjects with stable cardiovascular disease.

Serum troponin within the normal range is an emerging predictor of cardiovascular mortality. We aimed to determine how rapidly high-sensitivity troponin-I (hs-cTnI) levels are lowered by statin therapy in patients with stable cardiovascular disease. In the RADAR substudy, patients were randomized to atorvastatin 20mg/day (n=39) or rosuvastatin 10mg/day (n=39) and up-titrated at 6-week intervals to 80mg of atorvastatin or 40mg of rosuvastatin. Hs-cTnI concentrations were measured at baseline and at 6 and 18 weeks of follow-up. Statin treatment resulted in a mean change of serum hs-cTnI of -8.2% (P=0.010) after 6 weeks and -12.3% (P=0.001) after 18 weeks. After 18 weeks, hs-cTnI levels were lowered by 21.8% with atorvastatin and by 4.1% with rosuvastatin (P=0.001 and P=0.133, respectively). During statin therapy, serum hs-cTnI levels decreased rapidly within weeks of treatment, suggesting an effect beyond long-term atherosclerosis regression. Mechanisms that mediate this effect require further study.