Early statin use refined

DURHAM, N.C. -- While a class of cholesterol-lowering drugs known as statins are effective in reducing the chances of a second heart event for patients with coronary artery disease, a new analysis shows that only patients whose cholesterol levels are above the recommended guidelines are likely to benefit from receiving these drugs earlier than usual.

"While we know the benefits of statins in preventing subsequent heart events, few have looked at whether starting heart attack patients on the therapy earlier would have any benefit," said Duke University Medical Center cardiologist L. Kristin Newby, M.D., who published the results of her analysis today (June 19, 2002) in the Journal of the American Medical Association.

"Our analysis indicates that physicians should use caution in prescribing statins during the early phase of an acute coronary syndrome if their patients' LDL-cholesterol levels are lower than the 130 mg/dL guidelines," she continued. "Since it appears that there is a relationship between the LDL-cholesterol levels and the outcomes of early statin use, large clinical trials should be conducted to further refine which patients would benefit from this strategy."

Currently, physicians routinely prescribe statins to heart attack patients at or shortly after discharge from the hospital if their levels of LDL-cholesterol, the so-called "bad" form of cholesterol, are 130 milligrams per deciliter (mg/dL) or greater. Statins have proven to reduce LDL-cholesterol levels from 20 percent to 60 percent and can even increase the levels of the so-called 'good' HDL-cholesterol. The Duke researchers wanted to determine whether there would be any additional benefit to giving statins sooner while patients were still in the hospital after a heart attack.

The scientists found no difference in the 90-day and one-year rates of subsequent death or heart attack between patients who received early statins and those who received no statins. Additionally, they

Contact: Richard Merritt
Duke University Medical Center

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