New Prescribing Guidelines for Statins Could Improve Heart Attack Prevention

Refining approach for which patients are eligible for statin prescriptions could lower heart attack risk in younger patients.

A new approach has been developed to help determine which patients should receive statins in order to improve the prevention of heart disease.

A team from the Research Institute of the McGill University Health Centre (RI-MUHC) studied data from 2134 individuals in the National Health and Nutrition Examination Survey.

Investigators compared 2 approaches for statin eligibility that included a 10-year risk based approach currently being used and an individual benefit approach.

“Our study is changing the way we think about prescribing statins; we should not only be considering who is at risk of heart disease but, more importantly, who would benefit from these medications based on randomized clinical trial data,” said lead study author George Thanassoulis. “For example, younger patients who have high cholesterol, are frequently considered too young to be at risk for heart attack in the short term, but our analysis shows that they would benefit from treatment, even in the short term, and therefore should be eligible for statin treatment.”

The results of the study, published in Circulation, found that the individualized benefit approach produces greater eligibility for statins.

“Using a benefit-based approach, we identified 9.5 million lower-risk Americans not currently eligible for statin treatment, who had the same or greater expected benefit from statins as higher-risk individuals,” Dr. Thanassoulis said. “These individuals were lower-risk because they were younger but they also had higher levels of low-density lipoprotein cholesterol which we known to be an important cause of heart disease. Targeting statin treatment to this group would be expected to prevent an additional 266,000 heart attacks and strokes over 10 years.”

Researchers are no developing a web interface that will extend the use of the calculation model to include physicians, and they hope the new approach will help develop guideline recommendations that would help better identify patients who would benefit from statin therapy.

“This strategy will transform cardiovascular prevention for the better,” added study co-author, Allan Sniderman. “For too many, the present approach starts too late; an earlier start will multiply the lives saved.”