Cholesterol Drugs May Help in Cardiac Emergency

FRIDAY May 1, 2009 -- Giving patients a cholesterol-busting statin drug during a coronary emergency can save lives and reduce the incidence of longer-term problems, Czech researchers say.

The one-year risk of death or major heart problems was more than halved for people suffering life-threatening episodes of acute coronary syndrome who received the drugs, compared to those who didn't, cardiologists at the Na Homolce Hospital in Prague reported at an American Heart Association meeting in Washington, D.C.

Statins include widely used medications such as Crestor, Lescol, Lipitor, Pravachol and Zocor.

The study included 156 people treated at the hospital for acute coronary syndrome, which can typically involve the acute chest pain known as angina, and/or a heart attack. Half of the patients received usual emergency care, while the other half also received 80 milligrams a day of fluvastatin (Lescol) immediately and then every day for 30 days. Those who received the statin were encouraged to keep on taking the medication when they went home.

After one year, 10 of the 78 people (about 13 percent) who took the statin had died or suffered a major coronary problem, such as a heart attack or recurrent angina, compared to just under 27 percent (21 of 78) of those who didn't receive the drug, the researchers reported.

Only about 18 percent of those who received statins had problems requiring hospitalization during the follow-up period, compared to nearly 44 percent of those not taking the medication.

It's "a very small sample" but "consistent with what we know," said Dr. Robert A. Harrington, professor of medicine at Duke University and director of the Duke Clinical Research Institute.

The finding is "not novel," he said, since a number of other studies have shown benefits from the immediate use of statins in episodes of acute coronary syndrome.

For example, a 2007 review of 13 trials involving nearly 18,000 people hospitalized in the United States for acute coronary syndrome found a 24 percent reduction of adverse cardiovascular events such as heart attack and stroke among those given statin therapy. No significant difference was seen in the first four months after hospital discharge, but the benefit was clear after six months, and the reduced risk persisted for at least two years, that review found.

The major benefit noted in the Czech study was a nearly two-thirds reduction in angina, which occurred in 7.7 percent of those in the statin group versus 20.5 percent of those not taking the drug.

There was also an expected 29.5 percent reduction in blood levels of LDL ("bad") cholesterol among those who took the statin, the Czech physicians noted.

But the benefit seen in the study most likely was not due to the cholesterol-lowering effect of the statin, said AHA spokesman Dr. Alan Daugherty, assistant dean of research and director of the University of Kentucky Cardiovascular Research Center.

"Statins have unique anti-inflammatory properties that could contribute to the benefit," Daugherty said.

More information

There's more on statins at the American Heart Association.

Posted: May 2009


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