Rosuvastatin and cardiovascular disease: did the strongest statin hold the initial promises?

Rosuvastatin is the latest and most potent statin currently on the market. It has the greatest efficacy compared with all other available statins on total cholesterol and low-density lipoprotein cholesterol (LDL-C) reduction, and also provides a significant increase in high-density lipoprotein cholesterol (HDL-C) better than atorvastatin. Imaging studies showed a regression of atheroma in secondary prevention patients using an intravascular ultrasound technique and a hold of progression in primary prevention patients using carotid intima-media thickness as a surrogate marker. The JUPITER trial, a primary prevention large-scale, prospective study to examine the role of statin therapy in individuals with raised C-reactive protein but normal LDL-C levels, was recently terminated early due to a significant reduction of events in the rosuvastatin group. Rosuvastatin has held its initial promises as a very potent statin, with favourable effects on HDL, showing a regression or a halt of the atherosclerotic burden and reducing cardiovascular events in low-risk patients.