News Brief: Studies focus on effects of statins on heart patients
Discontinuing statin use in patients hospitalized for chest pain may triple their risk of death or heart attack, says a recent rapid access publication of Circulation: Journal of the American Heart Association.
"The message to physicians is: Don’t stop statins," says Christian W. Hamm, MD, one of the study’s authors. "Withdrawal of statin therapy shortly after the onset of symptoms completely eliminated the protective effect of statins in coronary heart disease patients hospitalized with severe chest pain," says Hamm, also director of cardiology at the Kerckhoff Heart Center in Bad Nauheim, Germany, and professor of medicine and cardiology at the University of Hamburg.
The study, published in the March 5 issue, investigated the effects of statins on the cardiac event rate in 1,616 patients who had coronary artery disease and chest pain in the previous 24 hours. These patients had previously participated in the international Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) study. PRISM compared the effectiveness of blood-thinners tirofiban vs. heparin in coronary heart disease patients hospitalized with accelerating heart pain.
Of the 465 hospitalized patients who had pretreated with statins (primarily simvastatin, lovastatin, or pravastatin — most with intermediate dosing) for at least six months, 86 were withdrawn from the therapy. Researchers then recorded death and nonfatal myocardial infarction (MI) during the 30-day follow-up. Patients who remained on statin therapy had half (0.49 times) the risk of death and nonfatal MI compared to those patients who did not receive statins throughout the study period. The patients who had their statin therapy withdrawn had 2.93 times the cardiac risk compared to patients who continued to receive statins and 1.69 times the risk compared to patients who never received statins. The patients withdrawn from statin therapy appeared to begin to lose the benefit of the drugs in as little as 24 hours.
"The increase in deaths and acute heart attacks was only explained by the statin withdrawal," Hamm says. The study did not look at people who take statins daily and who are not hospitalized.
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