Cholesterol Watch

Pharmacy Times, Volume 0, 0

Cholesterol-Lowering Meds May Reduce Pneumonia Death Risks

A study, reported in the October 27,2008, issue of the Archives of InternalMedicine, found that preadmission statinuse among patients admitted to thehospital for pneumonia is linked withlower rates of mortality.

For the study, the researchersreviewed data of 29,900 adults hospitalizedwith pneumonia for the first timebetween 1997 and 2007 in northernDenmark. Of these patients, 1372 weretaking statins when admitted to thehospital.

The findings indicated that within 30days, the patients taking statins whowere hospitalized with pneumonia had a31% lower risk of dying. By 90 days, thereduction in mortality was maintained,with those taking statins having a 25%lower risk of death.

"Our study adds to the accumulatingevidence that statin use is associatedwith improved prognosis after severeinfections," said lead researcher ReimarThomsen, MD. "Given the availability ofstatins, with their relatively low cost andmild adverse effects, positive resultsof statin therapy trials in patients withpneumonia would have substantial clinicaland public health implications."

Machine Pulls Bad Cholesterol Out of Blood

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

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

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

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

Statins May Lower PSA Levels

Men who take statins have lower blood levels of prostatespecificantigen (PSA), a biomarker for prostate cancer. Theresearchers caution, however, that the drop in PSA levels doesnot necessarily mean the drugs protect against the disease.

Robert Hamilton, MD, an author of the study reported in theOctober 28, 2008, issue of the Journal of the National CancerInstitute, said that it is possible that statins may offer someprotection against the disease. "The reduction in PSA was inproportion to the dose of statins that were taken and to thereduction of cholesterol levels." He said the study was conductedbecause of "encouraging recent data" from 4 previous studiesindicating a correlation between statin therapy and reducedPSA levels, and a lower risk of advanced prostate cancer.

The current study followed 1214 men prescribed statinsbetween 1990 and 2006 at the Durham Veterans AffairsMedical Center in North Carolina. The results showed abouta 4% decline in PSA levels after statin therapy was started.Significant reductions were seen in men who took the largestdoses of statins and had the biggest drops in blood cholesterollevels.

Future of Statins: Preventing Clots in Cancer Patients

A preliminary study found that statinsmay prevent blood clots in patients withbreast, lung, colon, and other solid-organcancers.

Experts, however, cautioned that randomizedcontrolled studies are neededbefore the results can be applied inthe clinical arena. The researchers atPhiladelphia's Albert Einstein MedicalCenter agreed on the preliminary natureof the findings.

For the study, the researchers reviewedmedical records for 740 patients admittedto the hospital with a diagnosis ofprostate, colon, lung, breast, stomach,esophageal, pancreatic, ovarian, kidney,or brain cancer between October 2004and September 2007. The analysis indicatedthat 8% of patients taking statinsdeveloped venous thromboembolism,compared with 21% in the control group.The participants in the control group hadnever used statins or used them for <2months.

The results were the same after adjustingfor smoking, metastatic disease, currentchemotherapy, immobilization, andaspirin use. The findings were recentlypresented at the American College ofChest Physicians' annual meeting.