Statins useful in heart patients with very low LDL

People with very low levels of "bad" LDL cholesterol who suffer a heart attack or other severe acute cardiac event may benefit from initiating a statin right after the event, a study shows.

Researchers took a look back at 155 patients hospitalized for an acute cardiac event who had very low LDL cholesterol levels and found that those individuals who were discharged from the hospital on statin therapy were much less likely to die or experience a second heart attack or stroke at six months, compared to those patients who were not discharged on statin therapy.

In the American Journal of Cardiology, Dr. Thomas T. Tsai from the University of Michigan in Ann Arbor and colleagues say their findings are consistent with findings of two other studies, which showed a decrease in cardiac events in subjects with severe acute heart disease (a.k.a., acute coronary syndrome or ACS) who were treated with high-dose statins, regardless of their LDL cholesterol level.

Moreover, they say their findings potentially extend the results of these studies to patients who have ACS and very low LDL cholesterol levels. In the current study, mean LDL levels on admission to the hospital were 63 milligrams per deciliter - well below the current treatment goal of less than 70 milligrams per deciliter in high-risk patients.

The findings suggest that patients who present with ACS and very low LDL cholesterol "may still derive benefit from statin therapy," the researchers conclude.

"It also may mean that the 'goal LDL' concept is outdated as a tool for defining candidacy for statin therapy in this situation," they assert.

The researchers emphasize that these hypothesis-generating findings "need to be confirmed in larger registries and with clinical trials."

SOURCE: American Journal of Cardiology, December 2005.