POSTED AT 10:44 PM EST    Monday, March 04
 
Stopping statins can be deadly
 

Associated Press
Dallas � Hospitalized heart patients who abruptly stop taking
cholesterol-lowering drugs suffer a rebound effect that makes them
three times more likely to die or have a heart attack than those who
stay on the medicine, researchers say.
The German researchers found that patients hospitalized for acute
chest pains lose the protective benefits of statin drugs in as little
as 24 hours after stopping the medicine because their nitric oxide
levels quickly fall to below-normal levels.
The study, published in Tuesday's issue of the journal Circulation,
did not look at people who take statins on a daily basis and do not
need to be hospitalized. Millions of North Americans take such drugs,
sold under such brand names as Lipitor, Zocor and Mevacor.
"The message to physicians is: Don't stop statins," said lead author
Christian Hamm, director of cardiology at the Kerckhoff Heart Center
in Bad Nauheim and professor of medicine and cardiology at the
University of Hamburg.
"We tried to show that the withdrawal of statins in humans results in
a rebound phenomenon and has an adverse impact on patients with acute
coronary syndromes."
In addition to lowering cholesterol, statins reduce artery
inflammation, hinder the blood's ability to clot, speed the growth of
muscle cells in the arteries and increase the release of protective
nitric oxide from the cells lining the inner walls of heart arteries,
Dr. Hamm said.
The study examined the medical records of 1,616 patients who
previously had participated in an international clinical trial
comparing the effectiveness of two blood-thinning drugs. The
researchers also looked at animal studies.
When admitted to the hospital, 465 patients had been taking statins
for six months. Statin therapy was continued in 379 patients and
discontinued in 86.
After 30 days, researchers examined the rates of death and non-fatal
heart attacks. Patients taken off the drugs after hospitalization
were 2.9 times more likely to die or have a heart attack than those
who stayed on the medication.
"The increase in deaths and acute heart attacks was only explained by
the statin withdrawal," Dr. Hamm said.
Since there are no guidelines specifically suggesting hospitalized
patients discontinue the use of statins, Dr. Hamm said doctors
probably assumed that statins were no longer beneficial or simply
forgot to continue the drugs.
Dr. James de Lemos, a cardiologist and professor at the University of
Texas Southwestern Medical School in Dallas, said the study shows
that statins work directly on the walls of blood vessels.
"This early rebound effect is a little surprising. We haven't thought
it was such a big deal to withdrawal this drug," he said. "We should
do everything we can to make sure patients are taking them in the
hospitals."




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