Heart Attack Patients Should Start Statin Drugs Before Leaving Hospital
Jan. 23, 2001 -- Doctors don't like to use terms like "miracle drugs," but heart specialists are finding it increasingly difficult to avoid the "M" word when discussing the cholesterol-lowering drugs known as statins. The drugs already are credited with saving lives by preventing first heart attacks as well as reducing the chances of second heart attacks, but new studies are adding to the "all good news, all the time" hype surrounding these drugs.
The newest study, published in this week's Journal of the American Medical Association,suggests that statins work even better at preventing death if they are started while a person is still in the hospital being treated for a heart attack. In another study released this week, researchers showed that taking a statin could reduce a person's risk of developing diabetes or suffering a stroke.
While many U.S. heart specialists are starting patients on statins at bedside in the hospital as standard practice, at least as many cardiologists wait a month or more after the heart attack before prescribing statin therapy for the patient.
Ulf Stenestrand, MD, tells WebMD that 5,528 Swedish patients who were sent home from the hospital "already taking a statin" were much less likely to die during the year following the heart attack than were 14,071 patients who weren't taking one of the statins when they were released from the hospital. Stenestrand is co-chair of a registry that tracks information about patients who are admitted to Swedish hospitals for treatment of heart attacks.
A year after the patients were sent home, the death rate among patients who went home taking a statin was 4%, compared to a mortality rate of more than 9% among patients who were sent home without the drug.
Because the study from Sweden is based only on medical records, heart expert Valentin Fuster, MD, PhD, tells WebMD that the results need to be interpreted cautiously.
"There could be some bias in these findings because a doctor may look at a patient who is not so sick and see a 'survivor' and decide to increase the chances of survival by giving that patient a statin. Other sicker patients may not be given a statin," Fuster says. Treating only healthier patients could make the drugs look better than they really are, says Fuster, who is director of the cardiovascular institute at Mount Sinai Medical Center in New York.
Although it's possible, Fuster doesn't really think that bias is behind this latest good news. When it comes to statin therapy, he tells WebMD that he believes in "the sooner, the better" approach. "This is what I, personally, am doing with my patients," he says. Fuster was not involved in the Swedish study.