Cholesterol Drugs May Help After Heart Surgery

NEW YORK (Reuters Health) - The proven benefits of statins, such as Zocor, and other cholesterol-lowering drugs for patients with established heart disease also extends to those who have recently undergone surgery or angioplasty to treat their disease, new research shows.

While large trials have conclusively shown that cholesterol-lowering therapy reduces rates of death and disease for patients with established heart disease, "the evidence for this benefit in patients previously undergoing (surgery or angioplasty) was less certain," Dr. James M. Brophy told Reuters Health.

"Moreover, clinical trials are often performed in selected populations -- for example women, the elderly or those with other medical conditions may be excluded -- and so the benefits of cholesterol lowering in 'real world' populations are also less certain," he added.

To address these concerns, Brophy and colleagues from McGill University in Montreal studied the impact of cholesterol-lowering therapies in all 11,958 patients over 65 years of age who underwent coronary bypass surgery or angioplasty in Quebec between 1995 and 1997.

During an average follow up of 3 years, 1,288 patients died, 810 had new heart attacks and 1,528 underwent a second operation to open the coronary blood vessels, the team reports in the American Heart Journal.

Use of cholesterol-lowering drugs after surgery or angioplasty was associated with a 34-percent decreased risk of death and a 23-percent decreased risk of heart attack. However, cholesterol-lowering therapy was not associated with a reduction in the need for repeat surgery or angioplasty.

"The take-home message from our study is that the results from the ideal world of clinical trials do translate into real world benefits" and that these benefits can be seen even in patients who require coronary surgery or angioplasty, Brophy said.

"The issue of cholesterol-lowering drugs in the elderly," he added, "is assuming increasing importance as the population ages and (surgery and angioplasty) rates in this segment of the population expand. In the enthusiasm for (these procedures), the benefits of these drugs shouldn't be forgotten."

SOURCE: American Heart Journal, August 2005.