Statin Might Help More People Fight Heart Disease Than Thought
Monday, November 10, 2008; 12:00 AM
SUNDAY, Nov. 9 (HealthDay News) -- A widely used cholesterol-lowering drug appears to protect against heart attacks, stroke and other adverse outcomes in people who do not have high cholesterol.
The patients receiving the drug, Crestor (rosuvastatin), did have high levels of C-reactive protein (CRP), a marker for the inflammation process which is implicated in hardening of the arteries.
The study, sponsored by drug maker AstraZeneca and conducted by researchers at Brigham and Women's Hospital in Boston and colleagues, was presented Sunday at the American Heart Association's annual scientific sessions, in New Orleans. It will also be published in the Nov. 20 issue of the New England Journal of Medicine.
Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardiovascular Disease at New York University's Langone Medical Center, believes these results will change practice and will expand the universe of people who can benefit from the drug.
"This article conveys clearly that if all you do is use LDL cholesterol as a discriminator for cardiovascular risk, you are going to underestimate cardiovascular risk substantially," he said. "Individuals even with modest LDL can have considerable cardiovascular risk when other factors are present."
One of the study authors agreed. "This shifts the paradigm for evaluating risk and treatment," said Dr. Antonio M. Gotto Jr., dean of Weill Cornell Medical College in New York City.
In a statement, Dr. Elizabeth G. Nabel, director of the U.S. National Heart, Lung, and Blood Institute (NHLBI), acknowledged this study and two others concerning CRP.
"New results from three studies being presented at the American Heart Association (AHA) Scientific Sessions in New Orleans and published in scientific journals today provide the strongest evidence to date that a simple blood test for high-sensitivity C-reactive protein (hsCRP) is a useful marker for cardiovascular disease," she said.
But other experts urged caution.
"We have to really not lose sight of traditional guidelines," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. "This is very interesting, but I think we have to wait and see."
According to the NHLBI, about 450,000 Americans will die of coronary heart disease, which is the leading cause of death for both men and women.
People with increased levels of CRP, a marker of inflammation, have a higher risk for cardiovascular events. And about half of all heart attacks and strokes occur in apparently healthy people with lower LDL levels.