Comparing different types of statins for secondary prevention of cardio-cerebrovascular disease from a national cohort study

Background Statins have been recommended for use in atherosclerotic cardio-cerebrovascular disease (CCVD). The purpose of this study was to investigate the efficacy of five different types of statin in the secondary prevention of CCVD in patients. Methods This study has a retrospective design and utilised data from the Korean National Health Insurance Service-National Health Screening Cohort. Participants aged 40 to 69 years at baseline were categorized into five statin groups (atorvastatin, rosuvastatin, pitavastatin, simvastatin, and pravastatin). The primary composite outcome was defined as recurrence of CCVD or all causes of death. Cox proportional hazard regression models were adopted after stepwise adjustments for confounders to investigate the difference in efficacy among the different statins. Results Of the 755 final study participants (485: atorvastatin, 34: pitavastatin, 8: pravastatin, 96: rosuvastatin, and 132: simvastatin group), 48 patients experienced primary composite outcomes. The median follow-up duration was 12.4 years across all groups. After stepwise adjustments, the hazard ratios (95% confidence intervals) for primary composite outcomes of atorvastatin, pitavastatin, and rosuvastatin groups were 0.956 (0.456–2.005), 1.347 (0.354–5.116), and 0.943 (0.317–2.803), respectively, when compared with the simvastatin group. Conclusions There were no significant differences between the statins in their efficacy for preventing recurrence of CCVD events and/or death in CCVD patients. However, further large-scale clinical trials are required to confirm these results.