Research: Statins cause heart disease

New research shows that statins, drugs which lower cholesterol, cause heart disease. These drugs cause calcified plaques to form in coronary arteries in humans, thus causing or worsening heart disease. A new study shows that the use of statins increases calcified plaque in coronary arteries. Coronary artery calcification is a measure of coronary atherosclerosis, predicts coronary heart disease, and has been described as the strongest predictor of cardiac risk in patients with no symptoms. The study was led by Ryo Nakazato of the Cedars-Sinai Heart Institute and Department of Imaging, Cedars-Sinai Medical Center, Los Angeles and examined 6673 subjects with no known coronary heart disease. One group of 2413 was on statins and another group of 4260 wasn't on statins. Those who used statins had a higher prevalence of obstructive coronary artery disease and a higher number of coronary segments that had calcified plaques. The study was published in the journal Atherosclerosis. Another recent study on diabetic subjects with advanced atherosclerosis also shows that frequent statin use causes accelerated coronary artery calcification. The study, published in the journal Diabetes Care, also shows that in those who weren't initially using statins, the progression of coronary and abdominal artery calcification was significantly increased in those who used statins frequently. Furthermore, another new study published in the Journal of the American College of Cardiology Foundation Cardiovascular Imaging also shows that CAC is associated with heart failure. Thus statin drugs can cause coronary heart disease by increasing coronary artery calcification in healthy and diabetic subjects. Previous research has also shown that statins don't reduce the risk of all-cause mortality. Because coronary artery calcification strongly predicts coronary heart disease, and statins increase artery calcification, their wide-spread use must be questioned. If you use statins, discuss their use with your doctor, and preferably with a cardiologist. CAC can be determined with electron beam computed tomography or multidetector computed tomography scan. Ask your cardiologist to undergo CAC scoring so you can evaluate the effects of the statins on your arteries and to make an educated decision if you should discontinue them or not

Crestor tops list for risk of muscle-related side effects

Rosuvastatin (Crestor, AstraZeneca) had a higher risk rate for muscle-related side effects than five other leading statins in an analysis of seven years of FDA adverse case reports. Higher potency agents were associated with elevated relative risk of adverse events, according to researchers, who recommended that physicians consider potency when prescribing statins to manage cholesterol. The results were published online August 22 in PLOS One

FDA adds warnings about memory loss and blood sugar to widely used class of cholesterol drugs (USA)

Federal health officials are adding new safety warnings about risks of memory loss and elevated blood sugar to statins, a widely prescribed group of cholesterol-lowering medications. The Food and Drug Administration announced several labeling changes to medicines like Lipitor, Crestor and Zocor. Labeling on all such drugs will warn of memory loss and confusion reported among certain patients taking statins. The problems were generally not serious and went away after patients stopped taking the drugs, according to the FDA. The updated labels will also mention elevated levels of blood sugar reported in some patients taking statins

Cholesterol-lowering medication accelerates depletion of plaque in arteries

In a new study, NYU Langone Medical Center researchers have discovered how cholesterol-lowering drugs called statins promote the breakdown of plaque in the arteries. The study was published online by the journal PLoS One on December 6, 2011. The findings support a large clinical study that recently showed patients taking high-doses of the cholesterol-lowering medications not only reduced their cholesterol levels but also reduced the amount of plaque in their arteries. However, until now researchers did not fully understand how statins could reduce atherosclerosis, the accumulation of fat and cholesterol that hardens into plaque in arteries, a major cause of mortality in Western countries. High blood cholesterol is a major culprit in atherosclerosis. As a result of narrowing arteries, blood clots can form or plaque can break off causing blockages in vessels. This can lead to a potentially fatal heart attack or stroke. "Our new research shows statins actually promote the regression of atherosclerosis by altering the expression of a specific cell surface receptor within plaque cells," said co-author of the study, Edward Fisher, MD, PhD, Leon H. Charney Professor of Cardiovascular Medicine and director of the Marc and Ruti Bell Vascular Biology Program at NYU Langone Medical Center. "This molecular phenomenon helps dissolve plaque by expelling coronary artery disease-causing cells from the plaque lining the arteries."

Gut bacteria may affect whether a statin drug lowers cholesterol

Statins can be effective at lowering cholesterol, but they have a perplexing tendency to work for some people and not others. Gut bacteria may be the reason. A research team led by a Duke University scientist has identified three bile acids produced by gut bacteria that were evident in people who responded well to a common cholesterol-lowering drug called simvastatin. The finding, published Oct. 13, 2011, in PLoS One, demonstrates how gut bacteria can cause inherent differences in the way people digest, metabolize and benefit from substances such as drugs. The study represents the intersection of two emerging research interests: An analysis of the intestinal microflora, plus the use of a science called metabolomics, which examines the thousands of biochemical components involved in cellular metabolism and how they affect health

Over-the-counter Lipitor? That's risky (Consumer Reports)

Pfizer hopes consumers will soon be able to get its cholesterol-lowering drug Lipitor (atorvastatin) without a prescription, according to two news reports. But our medical advisors say that's a bad idea because Lipitor and other statins are potent medications that can cause dangerous side effects, and should only be taken with a doctor's supervision. The company is likely looking for ways to make up lost sales - the drug racked up nearly $11 billion last year according to figures from IMS Health - when the patent expires in November. The Food and Drug Administration would have to grant permission for the switch, but that seems unlikely because it has previously said no to over-the-counter sales of two other statins - Mevacor (lovastatin) and Pravachol (pravastatin) - in part due to concerns about safety and that people who don't actually need the medications might take them - Consumer Reports

Statin use not linked to cancer, based on EMR data

Statins, a drug class administered to patients as an attempt to foil cardiovascular events, was not linked to an increased risk of cancer, according to the results of a retrospective analysis of more than 45,000 patients. The study, published in the July 26 issue of the Journal of the American College of Cardiology, may provide answers to the ongoing debate as to whether or not statins are linked to cancer

FDA announces new safety recommendations for high-dose simvastatin (USA)

The U.S. Food and Drug Administration is announcing safety label changes for the cholesterol-lowering medication simvastatin because the highest approved dose - 80 milligram (mg) - has been associated with an elevated risk of muscle injury or myopathy, particularly during the first 12 months of use. The agency is recommending that simvastatin 80 mg be used only in patients who have been taking this dose for 12 months or more and have not experienced any muscle toxicity. It should not be prescribed to new patients. There are also new contraindications and dose limitations for when simvastatin is taken with certain other medications

New heart attack jab even more effective than statins (UK)

British-based scientists have produced an antibody that reduces by more than 60 per cent the physical scarring of the heart and brain after an attack. The "milestone achievement" could also be used to stop the body attacking organ transplants. Professor Wilhelm Schwaeble, who carried out the work at Leicester University, said that it could potentially be the "biggest breakthrough ever" in the treatment of two of the biggest killers in Britain. Heart attacks and strokes are caused by blood flow being blocked by a clot or a bleed, starving parts of the body further down stream of oxygen. But most of the permanent damage is caused later – when circulation is eventually restored – and a "default of nature" which means the body's own defences attack the oxygen starved cells. This effect, which kicks in around nine to 12 hours after the attack or stroke, causes massive inflammation and more than 80 per cent of the permanent damage. It is this that often leads to death and massive reduction in the quality of life of stroke and heart attack survivors. Now the researchers at the University of Leicester have come up with an injection which they claim effectively stops the body attacking the oxygen starved cells. This allows them to start to oxygenate normally and the permanent damage is reduced significantly. The research was published in the Proceedings of the National Academy of Sciences

One U.S. patient in four takes statins

Far more patients are taking statin drugs today to aid cardiovascular health than they were 20 years ago, according to a new CDC report. Among Americans 45 and older, 25% were taking the lipid-lowering therapy in the period from 2005 to 2008, up from just 2% in 1988-1994, according to the National Center for Healthcare Statistics' report on health in the U.S. in 2010. Several cardiologists contacted by MedPage Today and ABC News remarked they were unaware that such a high proportion of patients take statins, but noted the findings go hand-in-hand with recent statistics on heart disease. "These results ... may explain some of the recent remarkable declines in hospitalizations for heart attacks and heart failure," Harlan Krumholz, MD, of Yale University, said. Still, researchers are hesitant to attribute all good outcomes in heart disease to statin drugs alone. "The decline in death rates comes from improved risk factor control, especially blood pressure reductions, smoking cessation and bans, improved lipids, and better care of heart attacks," James Stein, MD, of the University of Wisconsin, said.

Questions over statin prescribing

Healthy people may derive no benefit from taking cholesterol-lowering statins, according to a review of previous studies. The report, published in The Cochrane Library, concluded that statins reduced death rates. But it said there was no evidence to justify their use in people at low risk of developing heart disease. The British Heart Foundation said the benefits of prescribing statins for those people was unclear. Millions of people in the UK take statins, which reduce the risk of heart attacks and stroke by lowering the level of cholesterol in the blood. They are available both on prescription and in low doses over the counter in pharmacies - BBC

Statins before surgery can lower heart-attack risk (USA)

Cardiologists at the University of Florida's medical college have found that giving patients cholesterol-lowering statins before surgery and other invasive procedures can cut their risk of heart attacks, death and other complications by almost half, according to a new report in the Journal of the American College of Cardiology. "The magnitude of benefit we found in terms of reducing mortality, post-procedure myocardial infarctions and reduction in atrial fibrillation after bypass surgery is really quite large," said Dr. David Winchester, a cardiologist at UF's College of Medicine. "If you look at some of the other interventions we use, such as using beta blockers before surgery, you don't get nearly the kind of benefit that we are seeing with using statins prior to procedures. That is very surprising." They found that patients who took the therapy before surgery had a 43 percent lower risk of heart attack and 46 percent lower risk of atrial fibrillation. Post-surgery death rates were lower by 34 percent. Beneficial effects were seen when statins were administered as little as one day before surgery

Statins may cut arthritis risk, study suggests (Israel)

"Taking statins may reduce the risk of rheumatoid arthritis, a study suggests. Israeli researchers looked at 1.8m patients and found fewer incidents of the joint condition among those who took the cholesterol-busting drugs. It was thought statins could ease symptoms in those already diagnosed by stopping the over-production of tissue between the joints. But the Maccabi Healthcare Services Research Institute study suggested they could stop it developing altogether. The team discovered 2,500 cases of rheumatoid arthritis, the debilitating inflammation of the joints which affects about one in 100 people"

'Give out statins with junk food' (UK)

Fast food outlets should consider handing out cholesterol-lowering drugs to combat the effects of fatty food, say UK researchers. Taking a statin pill every day would offset the harm caused by a daily cheeseburger and milkshake, the Imperial College London team said. It would only cost 5p a customer - similar to a sachet of ketchup. But the British Heart Foundation warned an unhealthy diet does more harm than just raising cholesterol. Writing in the American Journal of Cardiology, Dr Darrel Francis and colleagues said it was about reducing harm in the same way that people who smoke are encouraged to use filters and those who drive are told to wear seatbelts. They took data from trials of almost 43,000 people to calculate whether the statins could override the effects of eating a junk food diet - BBC

Cholesterol drug side effects need watching: study (UK)

People using cholesterol-lowering statins have a higher risks of liver dysfunction, kidney failure, muscle weakness and cataracts and such side effects of the drug should be closely tracked, doctors said. In a study covering more than 2 million people in Britain, researchers from Nottingham University found that adverse side effects of statins, which are prescribed to people with high levels cholesterol to cut the risk of heart disease, were generally worst in the first year of treatment. The findings, published in the British Medical Journal, are unlikely to affect the use of best-selling medicines like Pfizer's Lipitor and AstraZeneca's Crestor, but the study's authors said patients taking statins should be "proactively monitored" for side effects. "Our study is likely to be useful for policy and planning purposes," said Julia Hippisley-Cox and Carol Coupland, the two professors who led the study. They said it may also be useful "for informing guidelines on the type and dose of statins". - Canwest

Statins may lower testosterone, libido

"Statin therapy prescribed to lower cholesterol also appears to lower testosterone, according to a new study that evaluated nearly 3,500 men who had erectile dysfunction or ED. "Current statin therapy is associated with a twofold increased prevalence of hypogonadism," a condition in which men don't produce enough testosterone, study author Giovanni Corona, MD, PHD, a researcher at the University of Florence in Italy, tells WebMD. Although previous studies have produced mixed findings on the possible link between taking cholesterol-lowering drugs and a drop in testosterone, most involved a limited number of patients, with few studies including more than 50 people, Corona says. "Our study is the first report showing a negative association between statin therapy and testosterone levels in a large series of patients consulting for sexual dysfunction," he says. About one of six adults in the U.S. has high cholesterol, according to the CDC. The number of people buying a statin (such as Lipitor or Zocor) rose 88% from 2000 to 2005, from 15.8 million people to 29.7 million, according to the federal Agency for Healthcare Research and Quality" - webMD

FDA warns about increased risk of muscle injury with Zocor (USA)

"The U.S. Food and Drug Administration has warned patients and healthcare providers about the potential for increased risk of muscle injury from the cholesterol-lowering medication Zocor (simvastatin) 80 mg. Although muscle injury (called myopathy) is a known side effect with all statins, [today's] warning highlights the greater risk of developing muscle injury, including rhabdomyolysis, for patients when they are prescribed and use higher doses of this drug. Rhabdomyolysis is the most serious form of myopathy and can lead to severe kidney damage, kidney failure, and sometimes death"

Watch out for infection if taking cholesterol drug simvastatin

"New research published in the Journal of Leukocyte Biology suggests that simvastatin negatively impacts the immune system's ability to clear infection and control inflammation in the presence of bacteria. Simvastatin might help us control our cholesterol, but when it comes to infection, it's an entirely different story says a new research study published in the Journal of Leukocyte Biology. In the research report, scientists from Italy show that simvastatin delivers a one-two punch to the immune system. First it impairs the ability of specialized immune cells, called macrophages, to kill pathogens. Then, it enhances production of molecules, called cytokines, which trigger and sustain inflammation. 'Statins are key drugs in the primary and secondary prevention of cardiovascular disease,' said Cosima T. Baldari, Ph.D., a scientist from the Department of Evolutionary Biology at the University of Siena in Siena, Italy, who was involved in the research. 'Our understanding of how these drugs affect the immune system should help maximize the benefits of these excellent drugs.'"

Statins may be linked to diabetes risk

"The popular class of cholesterol-lowering drugs called statins may slightly raise the risk of type 2 diabetes, but experts say the benefits of these potentially lifesaving drugs far outweigh the risks. A new review of 13 studies on statins and their side effects with a total of more than 91,140 participants found use of statins increased the risk of type 2 diabetes by 9%. This risk was found primarily among older people; there was no additional diabetes risk among statin users 60 and under. Researchers stress that this study does not prove that statins directly raise the risk of diabetes, but it raises the possibility of either a direct or indirect link between statins and diabetes that merits further investigation. They say the absolute risk of developing diabetes as a side effect of statin use is still small, especially compared to the much larger beneficial effect that statins have on reducing the risk of heart attack and other complications of heart disease" - webMD

Statins may worsen symptoms in some cardiac patients

Although statins are widely used to prevent heart attacks, strokes, and other cardiovascular disorders, new research shows that the class of drugs may actually have negative effects on some cardiac patients. A new study presented at CHEST 2009, the 75th annual international scientific assembly of the American College of Chest Physicians (ACCP), found that statins have beneficial effects on patients with systolic heart failure (SHF), but those with diastolic heart failure (DHF) experienced the opposite effect, including increased dyspnea, fatigue, and decreased exercise tolerance - Physorg.com