Cholesterol drug reduces heart attack and stroke risks
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Backus Hospital cardiologists are cautiously optimistic about a new study that found giving a cholesterol-lowering statin drug to patients with inflammation of the arteries can help reduce their risk of heart attacks, strokes and death by nearly half.
Nearly 18,000 patients were involved in the study, which was sponsored by AstraZenaca, the drug company that makes rosuvastatin, sold as Crestor.
"This is certainly a very important study," said Jai Chakrabarti, MD, a cardiologist on the Backus Medical Staff. "They took a bold view of this and treated people who didn't have a lot of classical risk factors with statins. They have moved the goal posts."
In the study, the volunteers had normal cholesterol levels, but they all had high blood levels of C-reactive protien, a signal of dangerous artery inflammation. Dr. Chakrabarti said this has been used as a predictor in the past, along with other risk factors. He said this study found treating people with high CRP levels resulted in fewer heart attacks, strokes and deaths.
"I think both cholesterol levels and CRP will be important. This is the first study that shows treating CRP aggressively reduces the risk of cardiac problems, and it would need to be followed up by other studies by the National Institutes of Health using generic statins," Dr. Chakrabarti said.
James Healy, MD, a cardiologist on the Backus Medical Staff, said this broadens the number of people eligible to be treated with statins. "We still have people who don't have risk factors who have coronary events, so there are things we have been missing. This is another factor to consider," he said.
The CRP test has been available, but doctors weren't always sure what to do with the results.
"This study also reaffirms the safety issues of statins, they are safe and effective," Dr. Healy said.
He said this study will affect family practice doctors who are on the preventative side of heart disease, whereas his office is often treating people who have already had a heart event and may be taking statins anyway.
Dr. Chakrabarti said this is a multi-factoral disease, with many risk factors, such as smoking, diabetes and high blood pressure. This will be one more factor to consider in creating a treatment plan.
Two things to consider, Dr. Healy said, are that the study was funded by a drug company and the doctors doing the study hold the patent on the CRP test. However, the science of the study shows that more people would benefit from taking statins.
Another concern both doctors mentioned is the cost to society for increasing the population taking the drugs. The study focused on Crestor, which costs about $3.45 a day, and it isn't completely clear whether generic statins would have the same effect.
Dr. Chakrabarti noted that there have been some safety concerns raised by the study, including that there was a statistically significant higher risk of diabetes in the patients who took Crestor. He said the reasons for this are still being debated, but doctors need to weigh any potential long term risks with the potential benefits to patients. He added that there is no data available on the long term safety of Crestor.