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Early statin treatment in MI cut mortality by 50 percent
Aug 29, 2005, 22:19, Reviewed by: Dr.
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"We were surprised that early statin therapy showed such a striking effect immediately after a heart attack"
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By University of California - Los Angeles,
In the largest clinical study of its kind, UCLA researchers found that early treatment with a statin drug within 24 hours of having a heart attack reduced in-hospital mortality rates by over 50 percent.
The new study, published in the Sept. 1 issue of the American Journal of Cardiology, demonstrates that early statin therapy may be essential for reducing mortality and other complications in heart attack victims.
"We've known that long-term statin therapy is beneficial, but this study provides the strongest clinical evidence to date supporting the early cardioprotective effects of statins immediately following a heart attack," said Dr. Gregg C. Fonarow, lead study author, The Eliot Corday Chair in Cardiovascular Medicine and Science and professor of cardiology, David Geffen School of Medicine at UCLA.
Researchers used data from over 170,000 patients taken from the National Registry of Mycocardial Infarction 4, a national database of patients who were admitted to a hospital due to a heart attack.
Researchers found that patients who had received statin therapy before hospitalization and within 24 hours following a heart attack had a 54 percent lower risk of in-hospital mortality compared to patients not on statin therapy.
Patients who had not received previous statin therapy, but who were newly started on the medication within 24 hours of hospitalization had a 58 percent reduction in mortality compared to patients not on statin therapy.
"We were surprised that early statin therapy showed such a striking effect immediately after a heart attack,"said Fonarow, director, Ahmanson-UCLA Cardiomyopathy Center. "We also found that statins provided additional protection from other heart attack complications as well."
The study showed that early statin use was associated with a lower incidence of cardiac arrest, cardiac shock, cardiac rupture and ventricular fibrillation that can all occur following a heart attack.
According to Fonarow, statins work by increasing nitric oxide in the cardiovascular system, which offers a number of benefits including reducing inflammation that may help limit cell damage from a heart attack.
The next step is to develop a clinical trial to corroborate these strong observational findings. Fonarow believes that early statin use within 24 hours of a heart attack may become a standard treatment. "As statins are already routinely started in myocardial infarction patients prior to hospital discharge, it would be relatively easy to administer this medication on arrival to the emergency department." This year 1.5 million Americans will have a new or recurrent heart attack. 
- Sept. 1 issue of the American Journal of Cardiology
University of California - Los Angeles
The study was funded by Genentech, Inc., the company that supports the National Registry of Myocardial Infarction 4.
Fonarow is a consultant and has done research for the following companies that manufacture statins: Merck & Co., Inc.; Pfizer, Inc. and Bristol-Myers Squibb Company.
Other authors include: R. Scott Wright, M.D., Mayo Clinic: Frederick A. Spencer, M.D., University of Massachusetts; Paul D. Frederick, MPH, MBA, Ovation Research Group; Wei Dong, M.D., Ph.D., Medical Affairs, Genentech, Inc.; Nathan Every, M.D., Ph.D., University of Washington; William J. French, M.D., Harbor-UCLA Medical Center.
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