Study: Wider use of cholesterol pills could save lives

New Orleans —- People with low cholesterol and no big risk for heart disease dramatically lowered their chances of dying or having a heart attack if they took the cholesterol pill Crestor, a large study has found.

The results, reported Sunday at an American Heart Association conference, were hailed as a watershed event in heart disease prevention. Doctors said the study might lead as many as 7 million more Americans to consider taking cholesterol-lowering statin drugs, sold as Crestor, Lipitor, Zocor or in generic form.

“This takes prevention to a whole new level, because it applies to patients who we now wouldn’t have any evidence to treat,” said Dr. W. Douglas Weaver, a Detroit cardiologist and president of the American College of Cardiology.

The study also gives the best evidence yet for using a new test to identify people who may need treatment, according to a statement from Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute.

However, some doctors urged caution. Crestor gave clear benefit in the study, but so few heart attacks and deaths occurred among these low-risk people that treating everyone like them in the United States could cost up to $9 billion a year —- “a difficult sell,” one expert said.

About 120 people would have to take Crestor for two years to prevent a single heart attack, stroke or death, said Dr. Mark Hlatky, a Stanford University cardiologist.

Statins are the world’s top-selling drugs. Until this study, all but Crestor have already been shown to cut the risk of heart attacks and death in people with high LDL, or bad cholesterol.

But half of all heart attacks occur in people with normal or low cholesterol, so doctors have been testing other ways to predict who is at risk.

One is high-sensitivity C-reactive protein, or CRP for short. It is a measure of inflammation, which can mean clogged arteries as well as less serious problems, such as an infection or injury. Doctors check CRP with a blood test that costs about $80 to have done.

A co-inventor on a patent of the test, Dr. Paul Ridker of Harvard-affiliated Brigham and Women’s Hospital in Boston, led the new study. It involved 17,802 people with high CRP and low LDL cholesterol (below 130) in the U.S. and 25 other countries..

They were randomly assigned to take dummy pills or Crestor, the strongest statin on the market, made by British-based AstraZeneca PLC. Neither participants nor their doctors knew who was taking what.

The study was supposed to last five years but was stopped in March, after about two years, when independent monitors saw that those taking Crestor were faring better than the others.

Full results were announced Sunday. Crestor reduced a combined measure —- heart attacks, strokes, heart-related deaths or hospitalizations, or the need for an artery-opening procedure —- by 44 percent.

“We reduced the risk of a heart attack by 54 percent, the risk of a stroke by 48 percent and the chance of needing bypass surgery or angioplasty by 46 percent,” Ridker said.

Remarkably, every single subgroup benefited from the drug.

“If you’re skinny it worked, if you’re heavy it worked. If you lived here or there, if you smoked, it worked,” Ridker said.

AstraZeneca paid for the study, and Ridker and other authors have consulted for the company and other statin makers.

One concern: More people in the Crestor group saw blood-sugar levels rise or were newly diagnosed with diabetes.

Crestor also has the highest rate among statins of a rare but serious muscle problem, so there are probably safer and cheaper ways to get the same benefits, said Dr. Sidney Wolfe of the consumer group Public Citizen.

CAUTION URGED

> Have a pacemaker or an implanted defibrillator? Don’t keep your iPod earbuds in your shirt pocket or draped around your neck —- even when they’re disconnected. A study led by Dr. William Maisel, a cardiologist at Beth Israel Deaconess Medical Center in Boston and a heart device consultant to the federal Food and Drug Administration, has found that some headphones can interfere with heart devices if held very close to them. They might even prevent a defibrillator from delivering a lifesaving shock.

> Vitamins C and E —- pills taken by millions of Americans —- do nothing to prevent heart disease in men, one of the largest and longest studies of these supplements has found. Vitamin E even appeared to raise the risk of bleeding strokes, according to results of the Physicians Health Study, presented Sunday and published online by the Journal of the American Medical Association.

—- From news services