Statins seem beneficial during heart attack

Patients suffering a heart attack may not fare as well if their cholesterol-lowering statin therapy is stopped in the first 24 hours, according to a new report.

Statin therapy, therefore, "should be continued during hospitalization" for a heart attack, unless there are clear reasons not to, recommend Dr. Frederick A. Spencer of the University of Massachusetts Medical School in Worcester and other investigators.

Although statin drugs are used primarily to control lipid levels, studies suggest that they also have other beneficial effects that may affect the outcome of heart attacks, the researchers explain in the Archives of Internal Medicine.

They compared outcomes in 78,224 patients who suffered a heart attack. Of these, 13,871 were taking a statin drug before hospital admission, which was stopped in 4870.

The in-hospital death rate was 12.5 percent among those for whom statins were discontinued, versus 4.9 percent for patients who continued taking statins, the team found. There was also a significantly increased rate of heart failure, lung congestion, shock, irregular heart rates, and cardiac arrest when statins were withdrawn.

Compared with patients who had not been taking a statin before their heart attack, outcomes were similar or actually slightly worse among those who stopped statin therapy.

These findings may indicate that damaging processes like inflammation or blood clot formation may rebound when statin drugs are stopped abruptly, Spencer and his associates conclude.

SOURCE: Archives of Internal Medicine, October 25, 2004.