Statin therapy benefits ACS patients with low LDL-cholesterol levels
A study of 155 patients examining the effects of statins on patients diagnosed with acute coronary syndrome (ACS) suggests that statin therapy may increase survival rates and potentially extends the results of larger, recently performed randomized trials to those with low-density lipoprotein cholesterol (LDL-C) levels of 80 mg/dL and below.
A study of 155 patients examining the effects of statins on patients diagnosed with acute coronary syndrome (ACS) suggests that statin therapy may increase survival rates and potentially extends the results of larger, recently performed randomized trials to those with low-density lipoprotein cholesterol (LDL-C) levels of 80 mg/dL and below.
However, researchers who performed the study of University of Michigan Medical Center patients cautioned that further research into the effects of statins on ACS patients is needed. "The results of our study should therefore be interpreted as generating a hypothesis," the authors of the study, which appeared in the American Journal of Cardiology, stated.
Patients who presented with unstable angina or myocardial infarction with LDL-C levels of 80 mg/dL and below were divided into those who were discharged on statin therapy (n=63) and those who were not (n=69).
Researchers used medical records to track patients' conditions while they received in-hospital treatment and then 6 months later with a composite end point of death, reinfarction, or stroke.
No significant differences were found between the 2 patient groups while examining clinical outcomes during in-hospital treatment. However, when comparing the 2 groups after 6 months, the composite end point was reached in 20 patients who had not received statin treatment compared with 6 patients in the group who had received statin treatment (P=.005)
By using a multivariate regression analysis, patients who had received statin treatment upon discharge from the hospital demonstrated an increased survival rate (adjusted OR=0.13; 95% CI, 0.03–0.92; P=.016). The same adjustment also demonstrated an association between statin treatment and a lower incidence of death, reinfarction or stroke (adjusted OR=0.24; 95% CI, 0.07–0.76; P=.016).
These results are consistent with randomized studies including the Pravastatin or Atorvastatin Evaluation and Infection Therapy (PROVE-IT) and Effects of Atorvastatin on Early Recurrent Ischemic Events in Acute Coronary Syndromes (MIRACL) trials, which reported an association between a reduction in cardiac events in ACS patients and high-dose statin therapy. An added finding in the University of Michigan study is that the mean LDL-C level of patients upon hospital admission was 63 mg/dL, substantially lower than those of the 2 larger studies, suggesting that patients with low LDL-C levels may be helped by statin therapy.
One limitation of the study was the lack of specific data on statins and doses among patients due to the retrospective nature of the study. The size of the study population also limited tracking of certain clinical variables such as anemia and diabetes.
SOURCE Tsai TT, Brahmajee KN, Mukherjee D, et al. Effects of statin use in patients with acute coronary syndrome. Am J Cardiol. 2005;96:1491–1493.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
