New Cholesterol Guidelines May Mean Fewer Cardiac Events

New high cholesterol treatment guidelines called for statins more often than old guidelines

(RxWiki News) Cholesterol guidelines released last year made many more people eligible for medicine to lower their cholesterol. Now, fewer people are experiencing heart problems and related death, new research suggests.

A recent study looked at how many heart events were prevented with statins, which are cholesterol-lowering medicines, under new guidelines.

"Ask your cardiologist about the benefits and risks of statins."

This study was written by Amit Khera, MD, director of the preventive cardiology program at the University of Texas Southwestern Medical Center in Dallas, and colleagues.

The American College of Cardiology and the American Heart Association released new guidelines for prescribing statins in 2013. They replaced the National Cholesterol Education Program/Third Adult Treatment panel recommendations.

To assess how well patients would do under the new guidelines, the authors used data from the Dallas Heart Study, which took place from 2000 to 2002 and involved people 30 to 65 years old. The researchers looked at the rate of atherosclerotic cardiovascular disease (ASCVD), which included coronary heart disease deaths, heart attacks, and fatal and nonfatal strokes.

The 2013 cholesterol guidelines recommended statins for patients with existing ASCVD, Type 2 diabetes and very high levels of LDL ("bad") cholesterol, as well as for those with a high 10-year risk for heart disease. The old guidelines suggested statins be given based on blood cholesterol levels.

Jeff Schussler, MD, FACC, FSCAI, interventional cardiology specialist of the Baylor Health Care System, said statin therapy is helpful in treating heart patients.

"Statin therapy is exceptionally helpful in protecting patients who are at risk for cardiovascular events," he told dailyRx News. "The benefit is even greater in those patients who have already had heart attacks or coronary events."

The authors looked at what percentage of 2,848 people would receive statins under the old and new guidelines. They found that, under the old guidelines, 17.2 percent of the sample would be given statins, but, under the new guidelines, 22 percent of the same group would receive statins.

Using the new guidelines would result in 3.6 to 4.9 more prevented ASCVD events for every 1,000 people screened and treated with moderate- or high-dose statins, the study authors found. About 4,500 serious heart problems would have been prevented in individuals 30 to 65 years of age over a 10-year period in Dallas County by following the new cholesterol guidelines, they suggested.

“This is one of the first studies to carefully predict the implications of the new guidelines in the general population beyond just the amount of increase in statin use,” Dr. Khera said in a press release. “Does it look like these new guidelines will prevent heart attacks and strokes? The answer is, ‘yes.’"

Prescribing statins to people older than 65 who qualify under the new guidelines would likely prevent even more cardiac events, the authors added.

"While they have not been entirely well received, the new guidelines expand the use of these medications," Dr. Schussler told dailyRx News. "While in the short term they may have increased some of the confusion, hopefully the net result will be expanded use in those who would benefit the most."

Dr. James de Lemos, one of the study’s authors, disclosed receiving fees from AstraZeneca, Sanofi/Regeneron and Amgen. Dr Jarett Berry, another study author, was a member of the Speakers Bureau for Merck & Co.

This study was published Aug. 5 in Circulation.

Review Date: 
August 20, 2014