***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Inflammation and oxidative stress are associated with atrial fibrillation ( AF ) .  Statins have antioxidant and anti-inflammatory properties . We tested if atorvastatin reduced AF recurrence after DC cardioversion ( CV ) by modifying systemic oxidative stress and inflammation ( NCT00252967 ) . METHODS AND RESULTS In a r and omized , double-blinded , placebo-controlled trial , patients with atrial fibrillation/flutter ( AF ) were r and omized to receive either  atorvastatin 80 mg ( n = 33 )  or placebo ( n = 31 ) before CV . Treatment was continued for 12 months or until AF recurred . Serum oxidative stress markers ( ratios of oxidized to reduced glutathione and cysteine , derivatives of reactive oxygen species , isoprostanes ) and inflammatory markers ( high-sensitivity C- reactive protein [ hs-CRP ] , interleukin-6 [ IL-6 ] , interleukin-1β[IL-1β ] , tumor necrosis factor alpha [ TNFα ] ) were measured at baseline and on follow-up . AF recurred in 22 ( 66.7 % ) of atorvastatin and 26 ( 83.9 % ) of placebo group ( P = 0.2 ) . The adjusted hazard ratio of having recurrence on atorvastatin versus on placebo was 0.99 ( 95 % CI : 0.98 - 1.01 , P = 0.3 ) . There was no significant difference in the time to recurrence using Kaplan-Meier survival estimates ( median [ IR ] : 29 [ 2 - 145 ] days versus 22 [ 7 - 70 ] days , P = 0.9 ) . Although no significant effect was seen on oxidative stress , 2 of 4 inflammatory markers , IL-6 ( adjusted OR : 0.59 , 95 % CI : 0.35 - 0.97 , P = 0.04 ) and hs-CRP ( adjusted OR : 0.59 , 95 % CI : 0.37 - 0.95 , P = 0.03 ) were significantly lowered with atorvastatin  . Cholesterol levels significantly decreased with atorvastatin ( P = 0.03 ) . CONCLUSIONS High-dose atorvastatin did not reduce the recurrence of AF after CV . It reduced selective markers of inflammation without affecting systemic oxidative stress . Failure of atorvastatin to prevent AF recurrence may be due to its failure to affect oxidative stress In a multicenter , open-label trial , 696 Hispanic patients with low-density lipoprotein ( LDL ) cholesterol levels > or = 130 and < or = 300 mg/dl and triglyceride levels < 400 mg/dl at medium or high risk of coronary heart disease were r and omized to receive 10 or 20 mg of rosuvastatin or 10 or 20 mg of atorvastatin for 6 weeks . At week 6 , LDL cholesterol was decreased more by 10 mg of rosuvastatin than by 10 mg of atorvastatin ( 45 % vs 36 % , p < 0.0001 ) and more by 20 mg of rosuvastatin than by 20 mg of atorvastatin ( 50 % vs 42 % , p < 0.0001 ) . Significantly greater decreases were also observed with rosuvastatin for total cholesterol , non-high-density lipoprotein cholesterol , apolipoprotein-B , and lipid ratios compared with milligram-equivalent doses of atorvastatin . Overall , National Cholesterol Education Program Adult Treatment Program III LDL cholesterol goals were achieved by 78 % and 88 % of patients who received 10 and 20 mg of rosuvastatin and by 60 % and 73 % of patients who received 10 and 20 mg of atorvastatin , respectively . Among high-risk patients , the LDL cholesterol goal of < 100 mg/dl was achieved by 74 % and 91 % of patients who received 10 and 20 mg of rosuvastatin and by 52 % and 62 % who received 10 and 20 mg of atorvastatin , respectively . All treatments were well tolerated , and adverse events were similar in frequency across treatment groups . No cases of myopathy or rhabdomyolysis were observed . In conclusion , treatment with rosuvastatin and atorvastatin produced beneficial lipid changes in this group of Hispanic patients that appear comparable in magnitude to those observed in primarily non-Hispanic white study population s. These benefits were accompanied by a favorable safety profile that suggests no concerns particular to this population Statin therapy may target both hypercholesterolemia and cholestasis in primary biliary cirrhosis ( PBC ) . However , little is known about the efficacy and safety of statins in PBC . The aim of this single‐center study was therefore to prospect ively examine the effects of atorvastatin on serum markers of cholestasis , aminotransferases , and lipid and bile acid metabolism as well as inflammatory and immunological markers in patients with PBC . Fifteen patients with early‐stage PBC and an incomplete biochemical response to ursodeoxycholic acid ( UDCA ) therapy ( defined as alkaline phosphatase 1.5‐fold above the upper limit of normal after 1 year ) were treated with atorvastatin 10 mg/day , 20 mg/day , and 40 mg/day for 4 weeks , respectively . Serum levels of alkaline phosphatase increased during atorvastatin 20 mg and 40 mg ( P < 0.05 ) , whereas leucine aminopeptidase and γ‐glutamyltransferase remained unchanged . No statistical differences in overall serum ALT , AST , bilirubin , and IgM levels were observed . However , atorvastatin was discontinued in 1 out of 15 patients because of ALT 2‐fold above baseline , and 2 patients showed ALT elevations 3‐fold above the upper limit of normal at the end of the atorvastatin treatment period . Serum total cholesterol and low‐density lipoprotein cholesterol levels decreased by 35 % and 49 % , respectively ( P < 0.001 ) . Precursors of cholesterol bio synthesis ( lanosterol , desmosterol , lathosterol ) showed a similar pattern . No changes in serum bile acid levels and composition were observed during treatment . Conclusion : Atorvastatin does not improve cholestasis in PBC patients with an incomplete biochemical response to UDCA but effectively reduces serum cholesterol levels . ( HEPATOLOGY 2007 . OBJECTIVE The primary objective of this study was to assess the cost-effectiveness of the most commonly prescribed doses of rosuvastatin , atorvastatin , simvastatin , and pravastatin for managing various lipid parameters in patients with hypercholesterolemia over a 1-year time horizon from a Canadian health care perspective . METHODS Incremental cost-effectiveness ratios ( ICERs ) were estimated for br and ed rosuvastatin compared with br and ed atorvastatin , generic simvastatin , and generic pravastatin in patients with hypercholesterolemia in terms of percent reduction in low-density lipoprotein cholesterol ( LDL-C ) and total cholesterol (TC)/high-density lipoprotein cholesterol ( HDL-C ) ratio , as well as in TC , HDL-C , triglycerides ( TG ) , apolipoprotein ( Apo ) B , the ApoB/ApoA-I ratio , and attainment of the Canadian LDL-C goal . The pharmacoeconomic model was constructed for a 1-year time horizon using efficacy data from a r and omized , open-label trial including 2268 adults and the wholesale acquisition costs of br and ed rosuvastatin and atorvastatin and generic simvastatin and pravastatin in British Columbia . RESULTS The most commonly prescribed doses of each of the 4 statins in British Columbia were as follows : rosuvastatin 10 mg ( 75.8 % of all rosuvastatin doses ) ; atorvastatin 10 and 20 mg ( 46.4 % and 35.3 % , respectively , of all atorvastatin doses ) ; simvastatin 20 and 40 mg ( 42.5 % and 31.8 % , respectively , of all simvastatin doses ) ; and pravastatin 20 and 40 mg ( 55.0 % and 34.1 % , respectively , of all pravastatin doses ) . Rosuvastatin 10 mg was dominant ( ie , was more effective at a lower cost ) relative to atorvastatin 10 and 20 mg , simvastatin 20 and 40 mg , and pravastatin 40 mg in terms of reductions in LDL-C , TC/ HDL-C ratio , TC , ApoB , and ApoB/ApoA-I ratio , increases in HDL-C , and attainment of the LDL-C goal . Compared with pravastatin 20 mg , the ICER per percent reduction in LDL-C , TC/HDL-C ratio , TC , TG , ApoB , or ApoB/ApoA-I or increase in HDL-C ranged from $ 3.89 to $ 26.07 ; the value for 1 additional patient achieving the LDL-C goal was $ 419.75 . When the statin doses were aggregated based on the Canadian statin-utilization pattern , rosuvastatin was dominant relative to atorvastatin on all effectiveness measures evaluated . When rosuvastatin was compared with generic simvastatin and pravastatin , the annual costs for 1 additional patient achieving the LDL-C goal were $ 144.51 and $ 373.91 , respectively . Based on the sensitivity analysis , rosuvastatin was associated with the highest probability of cost-effectiveness compared with the other statins over a broad range of monetary values per unit of clinical effect . CONCLUSION When percent changes in lipid parameters and rates of LDL-C goal attainment were considered in patients with hypercholesterolemia in British Columbia , rosuvastatin 10 mg was more cost-effective than the most frequently used doses of atorvastatin ( 10 and 20 mg ) , generic simvastatin ( 20 and 40 mg ) , and generic pravastatin ( 20 and 40 mg ) The primary objective of this 6-week , parallel-group , open-label , r and omized , multicenter trial was to compare rosuvastatin with atorvastatin , pravastatin , and simvastatin across dose ranges for reduction of low-density lipoprotein ( LDL ) cholesterol . Secondary objectives included comparing rosuvastatin with comparators for other lipid modifications and achievement of National Cholesterol Education Program Adult Treatment Panel III and Joint European Task Force LDL cholesterol goals . After a dietary lead-in period , 2,431 adults with hypercholesterolemia ( LDL cholesterol > or = 160 and < 250 mg/dl ; triglycerides < 400 mg/dl ) were r and omized to treatment with rosuvastatin 10 , 20 , 40 , or 80 mg ; atorvastatin 10 , 20 , 40 , or 80 mg ; simvastatin 10 , 20 , 40 , or 80 mg ; or pravastatin 10 , 20 , or 40 mg . At 6 weeks , across-dose analyses showed that rosuvastatin 10 to 80 mg reduced LDL cholesterol by a mean of 8.2 % more than atorvastatin 10 to 80 mg , 26 % more than pravastatin 10 to 40 mg , and 12 % to 18 % more than simvastatin 10 to 80 mg ( all p < 0.001 ) . Mean percent changes in high-density lipoprotein cholesterol in the rosuvastatin groups were + 7.7 % to + 9.6 % compared with + 2.1 % to + 6.8 % in all other groups . Across dose ranges , rosuvastatin reduced total cholesterol significantly more ( p < 0.001 ) than all comparators and triglycerides significantly more ( p < 0.001 ) than simvastatin and pravastatin . Adult Treatment Panel III LDL cholesterol goals were achieved by 82 % to 89 % of patients treated with rosuvastatin 10 to 40 mg compared with 69 % to 85 % of patients treated with atorvastatin 10 to 80 mg ; the European LDL cholesterol goal of < 3.0 mmol/L was achieved by 79 % to 92 % in rosuvastatin groups compared with 52 % to 81 % in atorvastatin groups . Drug tolerability was similar across treatments Background : Coronary heart disease ( CHD ) is the number one cause of death in Western societies . Elevated levels of plasma low-density lipoprotein ( LDL ) cholesterol and triglycer ides ( TG ) increase the risk for CHD . 3-Hydroxy-3 
    Output:
    
Log dose-response data revealed linear dose-related effects on blood total cholesterol , low-density lipoprotein (LDL)-cholesterol and triglycerides .
There was no significant dose-related effects of atorvastatin on blood high-density lipoprotein (HDL)-cholesterol .
Blood total cholesterol , LDL-cholesterol and triglyceride lowering effect of atorvastatin was dependent on dose .