Serious risk for heart attack

Putting patients with heart trouble on a high dosage of statin drugs quickly to lower their blood cholesterol levels offers only a marginal benefit compared to current treatment, a study said on Monday. Normally, patients at risk of another heart attack are first stabilized and put on low-cholesterol diets before introducing cholesterol-lowering drugs such as statins. But in the study funded by Merck & Co Inc, half the 4,500 patients were given a daily dose of 40 milligrams of simvastatin, which the company sells under the brand name Zocor, for 30 days and then raised to 80 milligrams daily. The drug was given within about four days of the initial heart "event." The other patients were given a placebo for four months, then put on a 20-milligram dose of simvastatin. While cholesterol levels dropped more sharply in the first group, the risks of suffering another heart attack, stroke, readmission to the hospital, or heart-related death were comparable in the two groups. Among those who went on the drug regimen right away, 14 percent suffered another heart event, compared to 17 percent taking a placebo initially -- a difference that was not seen as statistically significant. Patients were followed for between six months and two years. In addition, 0.4 percent of those on the heavier dose of simvastatin suffered from myopathy, a type of muscle pain and weakness, and statins can cause liver problems in a few cases, informs Reuter. According to Forbes, the combination of high blood pressure and high LDL cholesterol add up to serious risk for heart attack, says a Penn State College of Medicine study. Researchers examined data from about 14,500 people from four American communities who took part in the Atherosclerosis Risk in Communities Study and were followed for an average of nine years. People with high blood pressure had an incidence rate for heart attack of 16 cases per 10,000 people per year while those with high LDL cholesterol had an incidence of 12. The expected incidence for people with both elevated LDL cholesterol and high blood pressure might be expected to be 28 -- the sum of both risks. But this study found that people with both risks actually had a heart attack incidence rate of 51. "The observed disease rate due to the combination of these two risk factors was significantly higher than what was expected," lead investigator Dr. Duanping Liao, an associate professor of health evaluation sciences, said in a prepared statement. "In terms of excess risk, 31 percent of the risk of developing heart attack among people with both high blood pressure and elevated LDL cholesterol was attributable to the synergistic interaction of these two risk factors," Liao said. A study to see if patients who had just suffered heart attacks who took Merck & Co.'s (MRK) cholesterol drug Zocor would live longer without having another serious cardiac event than those who started statin therapy later and with a lower dose failed to reach statistical significance and was deemed inconclusive. The results of the study, announced at a medical meeting in Munich and in the new issue of the Journal of the American Medical Association, or Jama, on Monday come as a blow to Merck, which financed the 4,500-patient study to bolster the sales of its drug. The study did show a favorable trend toward reducing major cardiovascular events, but the numbers of patients suffering the events overall weren't large enough to bolster a definitive number. Merck had predicted that roughly 970 people would have these events -- death, nonfatal myocardial infarctions, readmission to the hospital for acute coronary syndrome and/or stroke. However, overall, only 652 such events actually occurred, Merck spokesman Tony Plohoros said. Adding to Merck's woes, nine of the patients taking the highest dose of Zocor -- 80 milligrams -- experienced muscle weakening. None of the patients taking lower doses experienced this, but one person in the placebo group did, publishes Smartmoney.

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