European Heart Journal Advance Access originally published online on September 5, 2005
European Heart Journal 2005 26(24):2664-2672; doi:10.1093/eurheartj/ehi482
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A COmparative study with rosuvastatin in subjects with METabolic Syndrome: results of the COMETS study
1Department of Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
2Department of Medicine, Baylor College of Medicine, Houston, TX, USA
3Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
41st Internal Department, University Hospital, Bratislava, Slovakia
5Department of Preventive Medicine, Ullevål University Hospital, Oslo, Norway
6Clinical Science, AstraZeneca, Macclesfield, UK
Received 23 May 2005; revised 5 August 2005; accepted 11 August 2005; online publish-ahead-of-print 5 September 2005.
* Corresponding author. Tel: +31 243 618819; fax: +31 243 541 734. E-mail address: a.stalenhoef{at}aig.umcn.nl
Aims The efficacy and safety of rosuvastatin, atorvastatin, and placebo were compared in patients with the metabolic syndrome.
Methods and results Patients with the metabolic syndrome with low-density lipoprotein cholesterol (LDL-C) 
3.36 mmol/L (130 mg/dL) and multiple risk factors conferring a 10-year coronary heart disease risk score of >10% were randomized (2:2:1) to receive rosuvastatin 10 mg, atorvastatin 10 mg, or placebo for 6 weeks. Subsequently, the rosuvastatin 10 mg and placebo groups received rosuvastatin 20 mg and the atorvastatin 10 mg group received atorvastatin 20 mg for 6 weeks. LDL-C was reduced significantly more in patients receiving rosuvastatin 10 mg when compared with those receiving atorvastatin 10 mg at 6 weeks [intention-to-treat (ITT) population by randomized treatment: 41.7 vs. 35.7%, P<0.001; ITT population by as-allocated treatment: 42.7 vs. 36.6%, P<0.001]. Significant LDL-C reductions were also observed in patients receiving rosuvastatin when compared with those receiving atorvastatin at 12 weeks (48.9 vs. 42.5%, P<0.001). More patients achieved LDL-C goals with rosuvastatin when compared with atorvastatin. Rosuvastatin increased high-density lipoprotein cholesterol significantly more than atorvastatin. Treatments were well tolerated.
Conclusion At equivalent doses, rosuvastatin had a significantly greater effect than atorvastatin in lowering LDL-C and improving the lipid profile and was well tolerated in patients with the metabolic syndrome.
Key Words: Metabolic syndrome • Statins • Low-density lipoprotein cholesterol
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