Stopping Statins Can Be Deadly
March 4, 2002 -- Stopping cholesterol-lowering statin drug therapy in people with heart disease can dramatically increase their risk of death. A new study found patients who discontinued using the drugs when they were hospitalized for chest pain were three times as likely to have a heart attack or die than those who kept taking their medication.
Researchers say the study adds evidence that statins may do more than just lower cholesterol, and that the drugs may protect the heart in other important ways. For example, recent research has shown that statins can reduce harmful inflammation in the arteries that can lead to blood clots.
But this study, published today in Circulation: Journal of the American Heart Association, also supports the idea that statins increase the release of protective nitric oxide in the inner walls of the heart. Animal research has shown that when the statins are suddenly withdrawn, a rebound effect occurs, and the nitric oxide levels drop below normal -- increasing the risk of heart attack or other cardiac events.
A human study to test this rebound effect would be unethical, but researchers were able to show a similar withdrawal effect in humans by looking at medical records of patients who'd been enrolled in an international heart disease trial.
Of the 465 patients who had been taking a statin drug for six months when admitted to the hospital for chest pains, 379 continued taking the drug, and 86 stopped. After 30 days, researchers looked at the number of patients who died or suffered a heart attack.
People who were kept on their statin medication had half the risk of death or a nonfatal heart attack than those who had never taken a statin drug. Those who stopped using statins after hospitalization had nearly three times the risk compared with those who continued using their medication.
"The increase in deaths and acute heart attacks was only explained by the statin withdrawal," says study author Christian W. Hamm, MD, of the Kerckhoff Heart Center in Bad Nauheim, Germany in a news release.
In addition, significantly more patients who had stopped statin therapy required additional procedures to restore blood flow within one week after hospitalization.
Hamm says there is no particular medical rule suggesting that hospitalized patients should discontinue statin drugs, so the physicians must have either assumed the statins were no longer beneficial or just forgot to continue the patients on the therapy.
"The message to physicians is: Don't stop statins," says Hamm.
Three statin drugs accounted for about 95% of those prescribed in the study and included Zocor, Mevacor, and Pravachol.