Life-saving prescriptions lagging in heart patients
NEW YORK (Reuters Health) - More than one in five people with heart disease aren't getting life-saving statin drugs despite guidelines saying they should, a new study shows.
Researchers looked at nearly 39,000 people who had experienced a heart attack or undergone heart surgery, and found about 8,600 people weren't prescribed the cholesterol-lowering medications.
Although there is still controversy over whether people should take statins to prevent heart attacks, research clearly shows the drugs benefit people who have already suffered a heart attack or a stroke.
"It's great that about 80 percent are on the medication, but we're short-changing almost 20 percent," said Dr. David Frid, a cardiologist at the Cleveland Clinic in Ohio who was not involved in the new work.
The study, published in the journal Circulation, tapped into a national outpatient registry designed to track quality of care in heart patients.
About five percent of the patients got cholesterol-lowering drugs other than statins, and 17 percent were left untreated.
Although the reasons not to treat are unclear, none of the patients had known contraindications to statins, which are recommended by the American Heart Association.
The medications lower "bad," or LDL, cholesterol and help people live longer after a heart attack. Brands include Pfizer's Lipitor and AstraZeneca's Crestor.
"Our study shows that half of untreated patients had low LDL levels," said Dr. Suzanne Arnold of Saint Luke's Mid America Heart Institute in Kansas City, who worked on the new findings.
"This supports the assumption that some doctors may not think patients with low LDL levels need lipid-lowering medication," she told Reuters Health.
But even in people with low LDL cholesterol, statins can provide a benefit, according to Arnold.
"Statins do more than just lower cholesterol," she said. "They also play a role in reducing plaque and inflammation in arteries. That benefits people regardless of their cholesterol levels."
The results are in line with data from last year showing one in six stroke patients leave the hospital without a statin prescription.
There can be a number of reasons why patients don't get statins, noted Frid of the Cleveland Clinic.
"Sometimes they don't get treated because they've had problems with the medication," he told Reuters Health. "Or they don't get treated because of how much it costs."
In 2010, Consumer Reports found that for people without insurance, a one-month supply of Lipitor averaged around $165. The cost for Crestor was similar.
In some people, statins can cause muscle pain and stomach problems such as nausea, gas, diarrhea or constipation. And their long-term effect on muscle tissue is unknown.
Still, Frid said the number of heart patients who get the drugs is disappointing.
"It should be at 100 percent unless the person can't be on a statin," he told Reuters Health.
SOURCE: bit.ly/rDd5g1 Circulation, November 11, 2011.
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