Cholesterol Watch

DECEMBER 01, 2008

Cholesterol-Lowering Meds May Reduce Pneumonia Death Risks

A study, reported in the October 27, 2008, issue of the Archives of Internal Medicine, found that preadmission statin use among patients admitted to the hospital for pneumonia is linked with lower rates of mortality.

For the study, the researchers reviewed data of 29,900 adults hospitalized with pneumonia for the first time between 1997 and 2007 in northern Denmark. Of these patients, 1372 were taking statins when admitted to the hospital.

The findings indicated that within 30 days, the patients taking statins who were hospitalized with pneumonia had a 31% lower risk of dying. By 90 days, the reduction in mortality was maintained, with those taking statins having a 25% lower risk of death.

"Our study adds to the accumulating evidence that statin use is associated with improved prognosis after severe infections," said lead researcher Reimar Thomsen, MD. "Given the availability of statins, with their relatively low cost and mild adverse effects, positive results of statin therapy trials in patients with pneumonia would have substantial clinical and public health implications."

Machine Pulls Bad Cholesterol Out of Blood

Barnes-Jewish Hospital (St. Louis, MO) has an unconventional method for treating cholesterol?low-density lipoprotein (LDL) apheresis machines that can pull the "bad" cholesterol right out of the patient's blood.

The method presents an additional treatment option for patients with the most serious cholesterol problems. The number of patients eligible for the treatment is small. To qualify, patients must have LDL levels that stay above 300 even after a 6-month regimen of statins, diet, and exercise. Patients with heart disease can get treatment if their LDL number is above 200.

The process eventually filters out 2.5 L of blood, almost half of the body's total. The procedure must be repeated every 2 weeks indefinitely because the LDL builds right back up in the bloodstream. The machine has been approved in the United States for almost a decade, but not many hospitals offer it because of the expense and the small number of eligible patients.

F A S T   F A C T: Elevated triglycerides are associated with an increased risk for coronary heart disease.

Statins May Lower PSA Levels

Men who take statins have lower blood levels of prostatespecific antigen (PSA), a biomarker for prostate cancer. The researchers caution, however, that the drop in PSA levels does not necessarily mean the drugs protect against the disease.

Robert Hamilton, MD, an author of the study reported in the October 28, 2008, issue of the Journal of the National Cancer Institute, said that it is possible that statins may offer some protection against the disease. "The reduction in PSA was in proportion to the dose of statins that were taken and to the reduction of cholesterol levels." He said the study was conducted because of "encouraging recent data" from 4 previous studies indicating a correlation between statin therapy and reduced PSA levels, and a lower risk of advanced prostate cancer.

The current study followed 1214 men prescribed statins between 1990 and 2006 at the Durham Veterans Affairs Medical Center in North Carolina. The results showed about a 4% decline in PSA levels after statin therapy was started. Significant reductions were seen in men who took the largest doses of statins and had the biggest drops in blood cholesterol levels.

Future of Statins: Preventing Clots in Cancer Patients

A preliminary study found that statins may prevent blood clots in patients with breast, lung, colon, and other solid-organ cancers.

Experts, however, cautioned that randomized controlled studies are needed before the results can be applied in the clinical arena. The researchers at Philadelphia's Albert Einstein Medical Center agreed on the preliminary nature of the findings.

For the study, the researchers reviewed medical records for 740 patients admitted to the hospital with a diagnosis of prostate, colon, lung, breast, stomach, esophageal, pancreatic, ovarian, kidney, or brain cancer between October 2004 and September 2007. The analysis indicated that 8% of patients taking statins developed venous thromboembolism, compared with 21% in the control group. The participants in the control group had never used statins or used them for <2 months.

The results were the same after adjusting for smoking, metastatic disease, current chemotherapy, immobilization, and aspirin use. The findings were recently presented at the American College of Chest Physicians' annual meeting.