Cholesterol Drug May Cut Heart Attack Risk

Study: Cholesterol-Lowering Statin Drug Lowered Risk Of Heart Attack, Stroke, Need For Bypass Surgery

(CBS/AP)  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 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 millions of more people, as many as 7 million more in the U.S. alone, to consider taking cholesterol-lowering statin drugs, sold as Crestor, Lipitor, Zocor or in generic form.

The dramatic results may change the way doctors prevent clogged arteries, reports CBS News medical correspondent Dr. Jonathan LaPook.

"We've known that half of all heart attacks and strokes occur in apparently healthy men and women with average or even low levels of cholesterol," says Dr. Paul Ridker, a cardiologist at Harvard-affiliated Brigham and Women's Hospital in Boston.

In the study, called the Jupiter trial, LaPook reports, doctors used statin because it lowers not only cholesterol but inflammation. Research suggests it's the combination of the two that leads to heart problems.

"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.

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.

"We've known that half of all heart attacks and strokes occur in apparently healthy men and women with average or even low levels of cholesterol," Ridker told the CBS Evening News.

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.

The Jupiter trial has already set off an online debate among physicians about what these results mean for their patients, LaPook reports. Click through some doctors' comments on the New England Journal of Medicine site here.

"What makes this so incredibly landmark is that we never looked at these end points; we never looked at just CRP, the inflammatory marker, as one of the invariables to decrease," Dr. Suzanne Steinbaum, a cardiologist, said on The Early Show. "Certainly, we have to look at CRP or inflammation as a huge role in the onset of heart disease and in treating it."

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. The new research will be considered by experts reviewing current guidelines.

"If you have any risk factors - high blood pressure, high cholesterol, diabetes - but all of these things have sort of been borderline and you're not taking a statin, really, this inflammatory marker, the CRP, might tip your doctor over the edge to give you a statin like Crestor," Steinbaum told Early Show anchor Harry Smith.

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 Stanford University cardiologist Dr. Mark Hlatky. He wrote an editorial accompanying the study published online.

"Everybody likes the idea of prevention. We need to slow down and ask how many people are we going to be treating with drugs for the rest of their lives to prevent heart disease, versus a lot of other things we're not doing" to improve health, Hlatky said.

A co-inventor on a patent of the test, Dr. Ridker 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.

One-fourth were black or Hispanic, and 40 percent were women - important because previous statin studies have included few women. Men had to be 50 or older; women, 60 or older. None had a history of heart problems or diabetes.

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.

Looked at another way, there were 136 heart-related problems per year for every 10,000 people taking dummy pills versus 77 for those on Crestor.

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.

"It is highly unlikely that (the benefits are) specific to Crestor," said Wolfe, who has campaigned against the drug in the past.

Researchers do not know whether the benefits seen in the study were due to reducing CRP or cholesterol, since Crestor did both.

This study and two other government-sponsored ones reported on Sunday "provide the strongest evidence to date" for testing C-reactive protein, and adding it to traditional risk measures could identify millions more people who would benefit from treatment, Nabel's statement says.

[kathy11112]

Mr. LaPook,

I think that you need to go back to school to find out about the harmful drugs that you are pushing. This study is inexcusable. The millions which are being put into tenuous health by prescriptions drugs are begging you to use your brain (and our money) for more intelligent uses. Why would this drug maker put people in danger when there was very little risk before? What happens when these 17,000 people get rhabdomyolysis or liver damage or renal damage or cancer or diabetes from this? Were these people informed that their right for redress (see FDA preemption) have been taken away by our bribed politicians? Our lists of disabled persons are growing at alarming rates - do we have the money to continue this stupidity or are you hoping the government will print some more money for the medical industry? PLEASE stop this insanity!

[drivelphobe]

I am disgusted with the medical community. My doctor, an internist, routinely hounds me to take an aspirin a day, Lipitor,(my cholesterol is 190), get my Shingles shot, get my colonoscopy and come in every year for an annual physical. His mind set seems to be that everyone needs these medications, not because they are symptomatic, but because he was taught in school to prescribe.

As I age, many more acquaintances develop medical complaints. I am shocked by the inability of numerous "specialists" who cannot concur nor accurately diagnose many common complaints. It feels like a game they play and no one can do a thing about it. One guy operates and claims relief will be the result. When it doesn''t work, another doctor says it''s something else.

Best way to go through the aging process is to realize that all things wear out and break in their good time. If you are bleeding, have broken bones, or unmanageable pain, that''s when you go to the
doctor. Don''t buy into their marketing that prevention is the answer. This is just the AMA''s way of making money treating absolutely healthy people.

I know very few people who weren''t sorry they opted for all the medical procedures that were recommended by physicians as they faced cancer and other terminal conditions. Their final days were spent in pain, with constantly healing incisions and nightmare schedules of doctor''s appointments and hospital stays. No way to end your life. Take charge of yourself at the end and die with dignity.

They are telling that a synthetic drug laced with side effects will improve our health. The medical profession has lost sight of healing people but has the insight to profit greatly from these poisons they pass out so freely. The "Greatest Scam in the History of Mankind" is the "Cholesterol Scam". Way to go CBS your advertisers mean more to you than the truth.

[wizann]

Again, CBS News shamefully reporting this advertisement as a story. The study was done by the company who makes it. That would be the first red flag. Plus, there is no documentation on side effects or long term adversities. You are not doing the American people any favors by pushing drugs on us. Maybe you should rethink you writes your checks or rename your show; maybe something like "Pharmacology News." Drug companies need to educate the trained physicians in this country not pander to the average television news watcher. But, hey, thanks for playing along CBS. And by the way, could you PLEASE sell advertising to any other company besides a drug company? PAAHHLLEASE! There are now more than a million people out of work, aren''t there any other companies looking for airtime who might have something to offer us besides drugs... maybe a new hope, a new job, a new prospect? Anything instead of telling us we are all substandard and on deaths doorstep if we don''t swallow 12 pills a day? Geez. Give us a break on the drugs already.

[ctla567]

Did they find something suspicious then end their "study"? No matter how you look at it there is just no way to justify lifelong consumption of a drug with only a two-year study. No doubt they are hiding something.

[jerr11]

Another phony study on behalf of the pharmacuetical companies.

The drug companies - making a killing while poisoning healthy people with their frankenstein concortions.

[wmmroth]

Medical Breakthrough or Profiteering in the Name of Medicine?

When the numbers are crunched we see that in the Crestor group there was about 1 cardiovascular event per 120 people, while in the placebo group, there were 2 events What this really means is that to prevent only one cardiovascular related event over a 2 year period, 120 people will have to take the drug Crestor for that 2 year period. But ...119 will have taken it for 2 years unnecessarily !

In the USA, Crestor costs about $3 per tablet. So our 119 people will have spent over $260,000 unnecessarily while AstraZeneca is laughing all the way to the bank. Multiply this by the millions of people that are currently taking statin drugs and those that AstraZeneca now wants to add ....and you can see the bigger picture.

When will the medical community, open their eyes to these profit driven drug companies who would unnecessarily (and possibly harmfully) treat millions of people with these potent statin drugs for the sake of huge profits. Why does the FDA allow this?

When will investments be made in studies that look to find and treat the real causes cardiovascular disease.

When will the doctor''s that many of us trust, stop throwing pills at at statistical risk factors?

Could it be that there is little profit in it ?

[colonieny]

Most informative discussion.

[oscarez]

I see two problems:
1. AstraZeneca paid for the study, and Ridker and other authors have consulted for the company and other statin makers.

2. The study was supposed to last five years but was stopped in March, after about two years.

There are bad BAD side effects but only two were covered in this report. Were side effects the reason the study was stopped after two years? Could it be because of high blood-sugar levels and a rise in newly diagnosed diabetes?

[jwig12]

What a great advertisement for crestor. How much did they pay the Early show to slant? Unless a person came to the web site and read the story, they would not have "part" of the full picture. Class effect of statins and hugh list of side effects was not mentioned. Talk about misleading the public...Have the Mortgage CEO''s moved to the drug companies?

[andor3]

"Hmmm... The study was funded by the maker of Crestor, who will obviously benefit from its results. Can you say conflict of interest?"

Yes the study is worthless or worse. Statin side-effects are intentionally buried but documented. Any company that concludes that vitually every American should take their pill daily is suspect.

Remember that cholesterol is an important, essential chemical in the body, brain, hormones and messing with it is not always good or healthy.

[incog-nito]

There''s a very recent study done by the Mayo Clinic. One group of patients take regular cholesterol drugs, the other a combination of red yeast rice and fish oil. There''s an excerpt of the results:

"The researchers noted that there was a reduction in LDL cholesterol levels in both groups. The alternative treatment group experienced a 42.4 percent reduction, and the statin group experienced a 39.6 percent reduction. Members of the alternative therapy group also had a substantial reduction in triglycerides, another form of fat found in the blood, and lost more weight."

http://www.mayoclinic.org/news2008-rst/4902.html

[incog-nito]

But the Pharmas finally won a long court battle to effective relegate Red Rice Yeast to a non-effective form.

They have Big Profit to make.

Posted by FloydZeppd at 07:12 PM : Nov 09, 2008

You can buy red yeast rice (the real thing) sold in jars or powder as a food coloring from Chinese grocery stores. Since they''re not sold as a supplement I doubt there''s any regulation on these.

[incog-nito]

Hmmm... The study was funded by the maker of Crestor, who will obviously benefit from its results. Can you say conflict of interest?

[garymed2]

hasn''t anyone out there heard that Transient Global Amnesia is caused by Statin drugs?
Check out "Lipitor, Thief of Memory" by Duane Graveline, MD.
It''s a very serious result of statins which the pharma''s want you to "forget" about.

[stick1772]

stupid people always looking for a drug to solve problems that are naturally cured by diet and exercise.

The drug companies just keep pushing these useless drugs on Americans in the hope to prevent .001% of heart attacks and other bull.

Wake up people. Do the math. If a drug reduces your chances of heart attack by 5-7% and your chances of heart attack are 3% without the drug you''re lowering your chances 1%. WHOOPIE!!!!

All these drugs do jack to help out and in alot of cases cause other side effects that require yet more drugs to stop.

Just stop and watch our medical costs plummet without the use of these drugs.

[godofredo29]

Saw a piece on NBC Nightly News with Bob Bazell trumpting the so-called results of this study. His reporting and the commentary of the experts focussed on the benefits of the medication for women, which seems true. However, it ignored the other negative for men (because of their testosterone), what the reporters and experts continue to describe as the "rare but serious side effect" regarding muscle pain. That is, rhabdomyolisis, not that rare and definitely serious and likely to be suffered by any guy who works out. What do you want to do guys? Do you want to be physically active or do you want to take a statin, because that''s the choice.

What a joke, this drug stops the manufacturing of COQ10 in the liver and that will give you heart disease. It is clear CBS knows where there advertising dollars come from.

[washrealtor]

"Statins are dangerous. They fry the brain ruining short term memory."
Posted by kevnkar

I was going to respond but I forgot what the subject was.

[rebel1935]

Statin drugs are useless and especially Crestor. I am the survivor of many statin drugs and I cannot tolerate the pollution in them.They cause me a lot of muscle pain and you will have a stroke or heart attack with lo choleaterol more often than high cholesterol. Cholesterol is a myth and a money maker for the medical doctors.
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