Not Getting Cholesterol Test and Not Drinking Statins Place Cardio Patient at Higher Risk
등록일 2019년 01월 07일 수요일
수정일 2017년 11월 15일 수요일

Photo By napocska via Shutterstock

Doctors have suggested that people who had suffered a stroke or heart attack recently should undergo a cholesterol test.If they do not follow up with the test, they are at a risk of another serious cardiovascular episode, The Deccan Chronicle reported.

An expert must measure the low-density lipoprotein, or bad cholesterol, which is the main source of clogged arteries that will make strokes and heart attacks more likely.A study on over 60,000 heart patients with an average age of 66 showed lower chances of a major adverse clinical event for people who take cholesterol-lowering medication.

Higher risk of dying

Kirk Knowlton, the director of cardiovascular research at the Intermountain Medical Center Heart Institute, disclosed that the risk of dying after three years with no LDL follow-up is 21 percent compared to a 5.9 percent risk for those who underwent a follow-up cholesterol test.

The researchers also discovered that patients who reached a reduction level of the B-type natriuretic peptide, a hormone, over their heart failure hospitalization showed a 30 percent lower rate of readmission to a hospital within 30 days of their first discharge, Medical.net reported.

This was based on an analysis of 6,887 patients with a primary diagnosis of heart failure discharged from the 22 hospitals of Interfaith between January 2014 and May 2017.The 30-day readmission rate of those patients was 21.1 percent, while the mortality rate was 12.8 percent.For patients who had a lower level of BNP was lower at 16.1 percent and mortality rate after 30 days was 7.1 percent.

Knowlton emphasized to doctors the value of follow-up therapy for patients with measurement of their LDL cholesterol.Patients also need to discuss or ask their doctors about the test, especially for those who had a stroke or heart attack.

Computing for the difference in BNP levels

The researchers determined the reduction in BNP among the Intermountain Healthcare heart failure patients by calculating the relative difference in BNP levels between the admission BNP and the discharge BNP during their hospital stay.Among the patients, 19 percent, or 1,315, had serial measurements.

Jose Benuzillo, an outcome analyst for the Institute's Cardiovascular Clinical Program, said more studies are needed to understand the interventions that caused the reduction in levels of BNP and which patients responded.They hope to determine the threshold level of BNP at which better readmission and mortality outcomes are reached.He added that relative change in BNP could help doctors determine which patients could benefit from advanced medical therapies or screening for end-of-life care.

However, many patients were not offered statins by their physicians even after they had experienced a stroke or heart attack, Daily Mail pointed out.In the UK, around 6 million adults are currently taking statins, but experts said that another 6 million people, considered high-risk patients, should be on statins.The reluctance to prescribe or take statins is due to worry over the drug's long-term effects because it has been linked to severe muscle pain, memory problems, and diabetes.

Dr.Jeffrey Anderson, the lead researcher, said he noted that patients who just had a major cardiovascular event were not always prescribed a statin.Others were not given doses high enough to provide optimal responses.

Although statins were a no-brainer, Simon Williams of Heart UK, a British cholesterol charity, agreed that statins were sometimes not offered to many heart attack patients.  It is because some cardiologists fix the heart attack by placing a stent and sending the patient home.This gives the patient the impression that all is fixed which is far from the truth.

Higher-dose statins in Asian patients

The reluctance to prescribe high-dose statins was quite common among Asian patients, Karol Watson, a cardiology professor at the David Geffen School of Medicine at the University of California, Los Angeles, said.It was because of the lack of evidence among Asian doctors that high-dose statins could lower heart risks in their patients, Medical Xpress noted.

Researchers gave statins to over 12,000 Japanese coronary artery disease patients, beginning with 1 milligram daily of pitavastatin for four weeks.They reported that patients with bad cholesterol went down to less than 130 milligrams/deciliter after the first four weeks after they randomly got a low or high dose of the statin for the next five years.At the end of five years, 6,214 were given 1-milligram doses and 6,199 the 4-milligram does.

The second group had fewer deaths from cardiovascular causes, fewer non-fatal heart attacks and strokes caused by blockages, and fewer hospitalizations caused by unstable chest pain at 4.3 percent compared to 5.4 percent for those who were given 1-milligram doses, the researchers said.

The Institute presented the research at the 2017 Scientific Sessions of the American Heart Association in Anaheim, California on November 12.Benuzillo said the study provided enough data on the benefits of conducting serial measurements of BNP and the relationship between better outcomes and reduced BNP rates.

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