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Higher Statin Doses Linked to Fewer Heart Attacks, Stroke
Date:11/9/2010

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When they did an updated analysis of the 21 trials, first major cardiovascular events (such as heart attack and stroke) were lowered by a "highly significant" 22 percent for a 1.07 millimole per liter (mmol/L) reduction of LDL cholesterol.

Taking all 26 trials together, deaths were reduced by 10 percent for 1 mmol/L in reduction of LDL cholesterol, with no significant effect on deaths from stroke or other vascular causes.

In addition, there were no significant effects of statins on deaths due to cancer or other non-vascular causes, and no excess risk of cancer, even at low LDL cholesterol concentrations.

The second study is a randomized trial called the Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH), led by professor Jane Armitage, also a scientist at the CTSU in Oxford.

This trial looked at the benefits of statin therapy with 80 milligrams (mg) versus 20 mg simvastatin (Zocor) among 12,000 heart attack survivors.

The study was supported by a grant from Merck (manufacturer of the simvastatin).

Over almost seven years of follow-up, those taking the higher dose statin had greater reductions in LDL cholesterol compared with those taking the lower dose.

The reduction in LDL cholesterol from the higher dose ended up decreasing the risk of a major cardiac event by 6 percent, the researchers found, although the statistic in itself was not clinically significant.

The researchers noted that the higher dose of Zocor (simvastatin) did result in a risk of a muscle disease 10 times higher than that associated with the lower dose. The muscle disease, known as myopathy, can cause pain, weakness, and in its rare but most severe form, destruction of the muscle tissue leading to kidney failure. Researchers found that two cases of myopathy occurred with the low dose and 53 cases with the higher dose.

Researchers also found that rhabdomyolysis -- the most severe form of
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