Research shows statin use reduces heart attacks, deaths after surgery on blood vessels

Statin cuts heart problems after artery surgery

NEW YORK — Score another victory for the cheap, cholesterol-lowering wonder drugs known as statins. People getting an artery unclogged or repaired were much less likely to die or have a heart attack afterward if they took preventive doses of the pills before and after their operations, a Dutch study showed.

Patients given Lescol had half the risk of having a heart attack or dying of a heart problem in the following month compared to those given dummy pills, the study found.

“You get a bonus with the treatment of statins,” said Dr. Don Poldermans, who led the study at the Erasmus Medical Center in Rotterdam, the Netherlands. The results are in Thursday’s New England Journal of Medicine.

Statins are widely prescribed to reduce cholesterol and prevent heart disease. Doctors wanted to see if statins could also protect against heart problems that are a common complication of blood vessel surgery — operations like repairing a bulging abdominal artery or unclogging arteries in the neck.

The stress of surgery on arteries can destabilize plaque buildup, causing it to rupture and blood clots to form, particularly in heart arteries. Statins are thought to help by reducing inflammation and stabilizing the plaque.

The researchers enrolled nearly 500 patients who were not on statins and were going to have operations on their aorta or leg or neck arteries. For about a month before and a month after their surgery, half the patients took a statin; the rest got a dummy pill.

Within a month of the operation, 12 patients in the statin group, about 5 percent, had died or had heart attacks, compared to 25 patients, or 10 percent, of those who took a dummy pill. Other signs of heart damage also were less common among those who had taken statins. There was no difference in side effects between the two groups.

When the study began in 2004, Poldermans said, statins were not as widely recommended as they are today for people with peripheral artery disease — stiff and narrow arteries, often in the legs. The patients in the study probably weren’t on statins before their surgery because their cholesterol levels were normal or near normal, he said.

“There’s no reason whatsoever to withhold statins anymore” from these patients,” Poldermans said.

Current guidelines recommend the drugs for everyone with peripheral artery disease, regardless of the need for surgery.

The Dutch study was partially funded by Swiss drug maker Novartis, which makes and supplied Lescol, also known as fluvastatin. Poldermans has received grants and consulting fees from Novartis; two other researchers have received fees and grants from medical companies.

Other statins on the market would likely achieve a comparable effect, said Dr. Alan T. Hirsch, director of the vascular medicine program at the Minneapolis Heart Institute and a spokesman for the American Heart Association. He said statins aren’t being used enough in people with peripheral artery disease, and he hopes the study draws attention to their benefits at the time of surgery, as well as throughout the lifetime of the patient.

“A statin is a seat belt when you drive a damaged artery,” he said.

On the Net:

New England Journal: www.nejm.org