Statin Therapy May Not Benefit All Patients with Heart Disease

Patients treated with statins who had high levels of LDL-C had an increased risk of cardiovascular events.

Only certain patients with stable ischemic heart disease (IHD) benefit from statins, while others do not, a recent study found.

Since patients with IHD have an increased risk of cardiovascular events, long-term treatment with cholesterol-lowering statins are recommended, according to the study published in JAMA Internal Medicine. The European Society of Cardiology recommends that statin treatments achieve a low-density lipoprotein cholesterol (LDL-C) level of below 70-mg/dl for patients.

Researchers in the study used LDL-C levels to compare the risk of major cardiac adverse events (MACE) for patients with IHD who have been receiving statins for at least 1 year. Low levels of LDL-C were considered to be less than or equal to 70-mg/dL; moderate levels were considered to be 70.1 to 100-mg/dL; high levels were considered to be 100.1 to 130-mg/dL, according to the study.

There were 31,619 patients included who adhered to their statin therapy at least 80% of the time. Approximately 29% of patients had low LDL-C levels, 53% had moderate levels, and 18% had high LDL-C levels, the researchers wrote.

Researchers found that patients with a low LDL-C level did not have a strong associated risk of MACE compared with patients who had a moderate level. They did find that patients who had moderate LDL-C levels were associated with a lower risk of MACE compared with patients who had high levels, according to the study.

"Our results do not provide support for a blanket principle that lower LDL-C is better for all patients in secondary prevention," the researchers concluded.