Cardiovascular outcome trial · N Engl J Med 2007
CORONA trial
Rosuvastatin in older patients with systolic heart failure.
The bottom line
In older patients with ischemic systolic heart failure, rosuvastatin lowered LDL cholesterol but did not reduce cardiovascular events or death, though it was safe and reduced cardiovascular hospitalizations.
No significant benefitUS status: US-approved
At a glance
- Medicine
- Rosuvastatin 10 mg per day
- Compared with
- Placebo
- People
- 5,011
- Who took part
- Patients at least 60 years of age with New York Heart Association class II, III, or IV ischemic, systolic heart failure
- Design
- randomized, placebo-controlled
- Follow-up
- Median follow-up of 32.8 months
- Main question
- Death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke (composite)
Main result
the primary outcome occurred in 692 patients in the rosuvastatin group and 732 in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.83 to 1.02; P=0.12)
Effect on LDL cholesterol
decreased levels of low-density lipoprotein cholesterol (difference between groups, 45.0%; P<0.001)
Other results
728 patients and 759 patients, respectively, died (hazard ratio, 0.95; 95% CI, 0.86 to 1.05; P=0.31); fewer hospitalizations for cardiovascular causes in the rosuvastatin group (2193) than in the placebo group (2564) (P<0.001)
Safety
No excessive episodes of muscle-related or other adverse events occurred in the rosuvastatin group.
In the trial's own words
“Rosuvastatin did not reduce the primary outcome or the number of deaths from any cause in older patients with systolic heart failure, although the drug did reduce the number of cardiovascular hospitalizations. The drug did not cause safety problems.”
Quoted from the abstract of N Engl J Med 2007, checked word for word against PubMed. PubMed 17984166 · Full paper (DOI)
How this medicine works, where it stands and what it costs: Statins
Common questions
What did the CORONA trial find?
In older patients with ischemic systolic heart failure, rosuvastatin lowered LDL cholesterol but did not reduce cardiovascular events or death, though it was safe and reduced cardiovascular hospitalizations.
Who was in CORONA?
5,011 people. Patients at least 60 years of age with New York Heart Association class II, III, or IV ischemic, systolic heart failure.
What was CORONA's main result?
the primary outcome occurred in 692 patients in the rosuvastatin group and 732 in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.83 to 1.02; P=0.12)
How much did LDL cholesterol change in CORONA?
decreased levels of low-density lipoprotein cholesterol (difference between groups, 45.0%; P<0.001)
Related trials
- SPARCL (2006)In patients with a recent stroke or TIA but no known coronary disease, high-dose atorvastatin modestly reduced recurrent stroke and cardiovascular events, though it slightly increased hemorrhagic stroke risk and did not improve overall mortality.
- JUPITER (2008)In apparently healthy people with normal LDL but elevated CRP, rosuvastatin significantly reduced major cardiovascular events and all-cause death, though with a higher rate of reported diabetes.
- IDEAL (2005)High-dose atorvastatin lowered LDL-C more than usual-dose simvastatin and reduced some secondary cardiovascular endpoints and nonfatal MI, but did not significantly reduce the primary composite of major coronary events or all-cause mortality after prior MI.
- TNT (2005)In patients with stable coronary disease, treating to a much lower LDL target with high-dose atorvastatin (80 mg) further reduced major cardiovascular events compared with the standard 10 mg dose, though with more liver enzyme elevations and no difference in overall mortality.
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