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  health > heart > story pageAIDSAlternative MedicineCancerDiet & FitnessHeartMenSeniorsWomen

Cholesterol-lowering drugs may work as well as heart surgery

Read what doctors have to say about nutrition and heart disease or ask your own questions.

Read what doctors say about reducing your risk of heart attack or ask your own questions.

Read what doctors have to say about angina or ask your own question.
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    Source: WebMD
  • July 7, 1999
    Web posted at: 5:10 p.m. EDT (2110 GMT)

    In this story:

    Treatments can work together

    Drugs highly recommended


    From Medical Correspondent Dr. Steve Salvatore

    (CNN) -- Heart disease is the leading cause of death in the United States. One of the most powerful weapons against heart disease is a powerful class of cholesterol-lowering drugs called "statins."

    Statins are so powerful a study in this week's New England Journal of Medicine suggests that in low-risk patients, aggressive cholesterol-lowering therapy with a statin drug called Lipitor is at least as effective as angioplasty in reducing episodes of low blood flow to the heart.

    Low blood flow can result in chest pain and heart attack. Angioplasty is a procedure where doctors place a catheter into the heart and use a balloon to open blocked coronary arteries.

    Researchers looked at 314 people with coronary heart disease who were considered to be at low risk because they did not have severe symptoms like chest pain.

    Of those, 164 were treated with 80 milligrams of Lipitor per day, and 177 underwent the angioplasty followed by the usual care, which could include a cholesterol-lowering treatment.

    "Those who were treated with medication had fewer hospitalizations over an 18-month period than those who received angioplasty," said Dr. W. Virgil Brown of Emory University.

    Twenty-two percent of those who received the statin therapy had an ischemic event as compared to 37 percent of the patients who underwent angioplasty. Ischemic events included death from heart attack, stroke, coronary artery bypass grafting, angioplasty and worsening chest pains.

    The study was done as part of the clinical trial Atorvastatin vs. Revascularization Treatments (AVERT) and was funded by Lipitor maker Parke-Davis, a division of Warner-Lambert.

    Treatments can work together

    Doctors caution the findings do not mean statins should be chosen over angioplasty.

    "If you are a patient with coronary disease and your doctor recommends a procedure like angioplasty, or a stent or bypass, make sure the doctor recommends right after that a statin to help lower your cholesterol," said Dr. David Vorchheimer, Mount Sinai Hospital.

    Lower cholesterol is key, and many people can't do it with diet alone.

    "Diet is the first treatment, but then the doctor needs to remeasure the cholesterol and the LDL (bad cholesterol), and if it's still above 100, they should be given medication to bring it below 100," said Brown.

    Drugs highly recommended

    Doctors say many patients are not getting these lifesaving medications.

    "Unfortunately we know in the United States that many, many patients who have blockages in their arteries don't really ever get a cholesterol-lowering drug. That was true in this study as well," Vorchheimer said.

    Doctors say they can't overemphasize the importance of cholesterol-lowering drugs. Medical research proves statins save lives.

    Angioplasty can help open an existing blockage, but lowering cholesterol plays a critical part in preventing blockages from forming in the first place.

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    September 3, 1999
    Study: Cholesterol drugs prevent heart attacks, yet seldom used
    March 8, 1999
    Studies find new value in overlooked heart-test results
    February 9, 1999
    Half of men, third of women will develop coronary heart disease, study finds
    January 7, 1999

    New England Journal of Medicine
    Mount Sinai Hospital
    Emory University
    American Heart Association
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