For 20% of CAD Patients, Statins May Not Be Enough
(HealthDay News) — Twenty percent of people with coronary artery disease experience little or no reduction in low-density lipoprotein (LDL) cholesterol from statin treatment, according to research published online Feb. 26 in Arteriosclerosis, Thrombosis, and Vascular Biology.
The finding has important implications for statin guidelines, lead researcher Stephen Nicholls, M.B.B.S., Ph.D., deputy director of the South Australian Health & Medical Research Institute in Adelaide, told HealthDay. "Cholesterol levels should continue to be monitored to ensure we are moving in the right direction," he said. "It is simply not good enough to prescribe [a statin] and move on." The analysis also underscores the need for new medications to target plaque build-up in statin nonresponders.
Nicholls' team analyzed seven studies involving a total of 647 patients with coronary artery disease taking statins. Ultrasound was used to compare the patients' arteries before and after statin therapy. Patients were followed for 18 to 24 months. Most patients saw significant decreases in LDL cholesterol. However, for 20 percent of the patients, LDL cholesterol levels either decreased only a little, remained the same, or increased.
Moreover, these nonresponders had faster plaque build-up in their arteries than patients who responded to statin therapy, the researchers found. Exactly why so many had a poor response isn't clear, they said. Nicholls said many patients -- responders and nonresponders alike -- take low doses of statins, which is not supported by the guidelines. Treating high cholesterol more aggressively is essential to lowering the risk of heart attacks and strokes, he said.