A new study from Harvard, presented last week at the American Heart Association meetings in Chicago, looked at 18,000 people admitted to the hospital with heart disease and followed them for over 6 years. The study found that adding the cholesterol-lowering drug Zetia to the standard statin drug simvastatin (the combination drug is known as Vytorin), decreased the risk of stroke by 20 percent, heart attack by 10 percent, and overall cardiac events by 6 percent.
I spoke with the study’s lead author, Dr. Chris Cannon, professor of cardiovascular medicine at Harvard Medical School, who said he believes this study moves the needle dramatically in the direction of “the lower the better” when it comes to lowering bad cholesterol, known as LDL, which clog coronary arteries with plaque and cause heart attacks.
Since the side effects of adding Zetia during the study was minimal, the combination therapy (Vytorin) looks more promising than previously. Statin drugs block the production of cholesterol by the liver. Zetia blocks absorption in the gut. Zetia can be useful in patients who need both and in those who don’t tolerate statins because of muscle aches or other side effects.
Cannon said the study shows that this combination therapy (Vytorin), will be useful in some patients who “need more than statins to get the LDL down.” He said he thinks the drug could also be useful for “primary prevention” in those at risk for heart attacks who haven’t yet had them.
This study could be a game changer, since last year the American Heart Association guidelines recommended getting total cholesterol below 180 but with no specific ideal target for LDL (bad) cholesterol. But the new study appeared to show that an LDL as low as 60 was preferential in preventing a cardiac event, which may impact future AHA guidelines.
At the heart meetings another drug, alirocumab, was shown to work on the liver to lower cholesterol. It too may prove useful in those who need their cholesterol lowered but can’t tolerate statins.
The heart prevention focus this year is back to lowering cholesterol as part of an overall improvement in lifestyle.
Cholesterol – Google News