Study: Statin Drug Reverses Coronary Artery Disease
MICHELE NORRIS, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.
ROBERT SIEGEL, host:
And I'm Robert Siegel.
Every day, millions of Americans take drugs called statins to lower their cholesterol. But patients' arteries remain clogged. Well today, researchers report that more aggressive treatment with a statin called Crestor can actually remove artery deposits.
NPR's Richard Knox reports.
RICHARD KNOX reporting:
Statin drugs are a major medical success story. But doctor Steven Nissin of the Cleveland Clinic says up until now they haven't actually reversed heart disease.
Dr. STEVEN NISSIN (Cardiologist, Cleveland Clinic): If we put these drugs in the water supply, cardiovascular disease would still be the leading cause of death in America.
KNOX: Current national guidelines say people should aim to get their levels of LDL, or bad cholesterol, below 100. That may be part of the problem.
Dr. NISSIN: Maybe we just weren't getting cholesterol levels low enough. If you go to primitive cultures, the levels of the LDL cholesterol, or bad cholesterol, are very low, as low as 50 or 60.
KNOX: But that's not the whole story. Nissin thinks you also have to raise levels of HDL, known as the good cholesterol. That's because HDL sucks bad cholesterol out of artery linings and transports it to the liver where it can be turned into bile and excreted.
So researchers in eight hospitals around the country decided to give several hundred heart disease patients the maximum dose of a statin drug called rosuvastatin, known by the brand name Crestor. It's a potent reducer of bad cholesterol, but it also raises good cholesterol.
After two years on high-dose rosuvastatin, LDL levels went from an average of 130 to 63.
Dr. NISSIN: That was a 53% reduction. This is the largest reduction every observed in a outcomes trial for statins. Also, and perhaps somewhat surprisingly, their levels of good cholesterol, or HDL, rose by nearly 15% and that is also unprecedented.
KNOX: But the important thing was what researchers saw when they looked inside patients' arteries using a tiny probe that makes ultrasound pictures.
Dr. NISSIN: We saw anywhere between about 6.8 and 9.1 percent of the plaque was actually gone from the artery.
KNOX: Plaque is the cholesterol-laden gunk that narrows arteries. Sometimes it breaks off, causing heart attacks and strokes. Removing plaque is the holy grail for heart researchers. It's undoing years of disease.
Nissin presented the results at the American College of Cardiology meeting in Atlanta.
The good news comes with a number of caveats. The study did not actually demonstrate that patients had fewer heart attacks or deaths. It did not compare patients taking high-dose rosuvastatin with others taking a sugar pill or another statin. And, the study was funded by the makers of Crestor.
Dr. ROGER BLUMENTHAL (Cardiologist, Johns Hopkins Medical School): This is not a home run, but it's certainly a stand-up double.
KNOX: Doctor Roger Blumenthal is head of preventive cardiology at Johns Hopkins Medical School.
Mr. BLUMENTHAL: The amount of reversal or regression they saw was modest.
KNOX: Still, Blumenthal says other, bigger studies are under way that should show whether radical lowering of bad cholesterol while raising good cholesterol pays off in fewer heart attacks, strokes, and cardiovascular deaths.
They'll also have to show that high doses of statins are safe. Nissin and Blumenthal have no doubts about that, but Dr. Sydney Wolfe, of the Health Research Group says when Crestor first came on the market, doctors reported a higher rate of muscle and kidney problems than for other statins. Federal regulars dismissed those reports, but Wolfe remains skeptical.
Richard Knox, NPR News.
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