Heart attacks and strokes may be cut by
roughly 50 percent among patients who receive preventive doses of a cholesterol-lowering
drug known as a statin, according to a large medical study involving 18,000
patients in 26 countries. The study conducted by scientists from Birmingham and Women’s
Hospital focused on the drug rosuvastatin, sold as Crestor by drug maker
AstraZeneca, which funded the research.
For the study, scientists used a test they
pioneered, a tool to screen patients for evidence of cardiovascular disease missed
by other cholesterol tests. All participants in the study had very good
cholesterol levels but elevated levels of a protein that has been linked to
heart disease. The benefits were seen in patients with high levels of a protein
called CRP, a phase protein produced by the liver and by adipocytes that points
to an inflammation in the body and can be a factor in the development of
coronary heart disease, a major cause of disability and death. The participants
took 20 milligrams of the drug Rosuvastatin, also known as Crestor, or a
placebo pill.
At the end of the study (it was supposed to
last four years, but the effects were so beneficial that the study was halted
after less than two years, the researchers said) people who took Crestor were
also almost 50 percent less likely to suffer a stroke, need angioplasty or
bypass surgery, and were about 20 percent less likely to die of heart disease.
Healthy people may benefit from statins too,
the study shows. “If your high sensitivity CRP (hsCRP) is high, you should be
on statin therapy regardless of your cholesterol level. This is an approach we
can start using tomorrow,” said Dr. James Willerson, director of the Texas
Heart Institute in Houston.
Statins are usually prescribed to reduce
heart risk in people with underlying heart conditions by lowering the amount of
cholesterol in the blood. The drugs work by blocking the enzyme
HMG-CoA-reductase, which is needed by the body to make cholesterol. The most
common adverse side effects found to be associated with the use of statins
include muscle pain and muscle weakness.
Drug analysts say the results of the study,
presented Sunday at a New Orleans
meeting of the American Heart Association, may help AstraZeneca to promote
Crestor. They estimate Crestors’ yearly sales will reach $6.33 million by 2015,
expanding the $34 billion market for all cholesterol-lowering medicine and
preventing 50,000 heart complications a year.
The findings of the study, published in the
New England Journal of Medicine, will
be taken into “strong consideration” by the National Heart, Lung, and Blood
Institute as it revises guidelines on preventing and treating heart attack and
stroke next year, said Dr. Elizabeth Nabel, the agency's director. The results
suggest an additional 6 million men over age 50 and woman over age 60 should
take the drugs, doctors said.
Another interesting phenomenon, noticed by
Paul Ridker, the lead investigator from Harvard
Medical School
in Boston was
that half of heart attacks and strokes happen among apparently healthy men and
women with normal or low levels of cholesterol. Doctors cannot assume their
patients are at low risk of heart disease just because their cholesterol level
is normal or low.
Besides reducing heart risk, statins were
shown to slow down age-related memory loss and dementia as well.
The study, dubbed Jupiter, highlights the
importance of prevention and raises the question of whether statins should be
used to develop therapies that would offer an effective prevention for heart
disease, America’s
number one killer.