October 2006: New research suggests that statins can significantly reduce the incidence of stroke, myocardial infarction (MI), or all-cause death in patients with severe carotid arterial disease not revascularized. The study, presented at CHEST 2006, the 72nd annual international scientific assembly of the American College of Chest Physicians (ACCP), showed that statins notably reduced such incidences in these nonrevascularized patients with chronic high cholesterol, as well.
"Statins reduce the LDL, or bad cholesterol and increase HDL, or good cholesterol," said lead author Gautham Ravipati, MD, New York Medical College, Valhalla, NY. "Our study focuses on statin use in patients with severe, carotid artery disease, and our data favor the use of statins in order to reduce the incidence of stroke, MI, and all-cause mortality in this population."
From January 2001 to December 2005, Dr. Ravipati and his colleagues analyzed the charts of 449 patients (59 percent men) with carotid arterial disease, of which 298 were treated with statins and 151 were not. Patient follow-up occurred within a mean of 26 months for the statin groups and 21 months for the control group.
Researchers identified hypercholesterolemia, or high cholesterol, in 100 percent of patients treated with statins and in 96 percent of those treated without. Patients showed no significant differences in age, gender, hypertension, diabetes, smoking, stroke, or MI. However, all patients had experienced a narrowing of one or two carotid arteries, and none of the patients had been revascularized.
Results revealed that the incidence of stroke, MI, or death in patients treated with statins was 15 percent, compared with a significantly higher 68 percent, in patients who were not treated with statins. Researchers also found that statins were effective in both diabetics and in nondiabetics with severe carotid arterial disease.
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"Research like this, involving these types of incidences on these types of patients, has not previously been published," Dr. Ravipati said. "And what it supports is that all patients with carotid arterial disease and hypercholesterolemia should be treated with statins, unless there is an absolute contradiction."
"Recent studies have examined the use of statins in the prevention of stroke," said Mark J. Rosen, MD, FCCP, President of the American College of Chest Physicians. "The results of this study are encouraging and confirm a potential role for statins in the management of stroke and heart disease."
CHEST 2006 is the 72nd annual international scientific assembly of the American College of Chest Physicians, held October 21-26 in Salt Lake City, UT. ACCP represents 16,500 members who provide clinical respiratory, critical care, sleep, and cardiothoracic patient care in the United States and throughout the world.
The ACCP�s mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication. For more information about the ACCP, please visit the ACCP Web site at http://www.chestnet.org.
Source: American College of Chest Physicians
