14 Mar Younger People May Benefit From Statins
MedicalResearch.com Interview with:
Dr. George Thanassoulis
Dr George Thanassoulis MD MSc FRCPC
McGill University Health Center and Research Institute
Montreal, Quebec, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Thanassoulis: Currently statins are recommended in most countries worldwide based on 10-yr risk of heart disease but because age is the best predictor of future heart disease this leads to many more older patients being eligible for statins at the expense of younger people. This means that even young patients with higher levels of low-density cholesterol, a known cause of heart disease, are not eligible for statins until they are much older. However, waiting for these individuals to become “old enough for treatment” permits their higher LDL to continue to damage their arteries leading, in some cases, to advanced coronary disease at the time when statins are finally stated. So we are missing an opportunity to effectively prevent heart disease.
What our analysis shows is that we need to consider not just someone’s risk of having a heart attack but also whether they would be expected to benefit from statins. By integrating information from randomized trials we were able to show that there were over 9.5 million Americans who were at low risk (and not eligible for statin therapy) that would have the same absolute benefit as higher risk people who we currently treat. These patients, as expected, were younger but had higher levels of LDL cholesterol. We also showed that statin therapy in these individuals would avoid more than 250,000 cardiac events over 10 years.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Thanassoulis: The main message here is that it is equally important, if not more important, to consider “who benefits from statins?” rather than simply considering “who is at risk for heart disease?”. We hope that physicians, their patients and also future guideline groups consider the importance of considering benefit in determining who should take statins.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Thanassoulis: We need to determine the cost-effectivess of our approach to establish what benefit threshold is optimal for determining eligibility. We also would like to incorporate additional information into our individualized benefit model including possibly coronary calcium, apoB as well as genetics.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
Individualized Statin Benefit for Determining Statin Eligibility in the Primary Prevention of Cardiovascular Disease
George Thanassoulis, Ken Williams, Kathleen Kimler Altobelli, Michael J. Pencina, Christopher P. Cannon, and Allan D. Sniderman
Circulation. 2016;CIRCULATIONAHA.115.018383published online before print March 4 2016, doi:10.1161/CIRCULATIONAHA.115.018383
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Dr. George Thanassoulis (2016). Younger People May Benefit From Statins MedicalResearch.com
Last Updated on March 14, 2016 by Marie Benz MD FAAD