Statin drugs have received recognition for stabilizing plaque and for reducing the risk of further cardiac events in patients with known heart disease. I am certainly not the only clinician, therefore, to extrapolate from this the usefulness of these drugs in patients who have never had a heart attack but are definitely at serious risk for one.
Over the next few years, I am certain that statins will emerge from the false and unsubstantiated rumors of associated memory loss and receive the full recognition they deserve for battling heart disease before it ever becomes clinically apparent.
Of course, the first such study has slipped below the media radar. At a time when drug-bashing remains in vogue, the groundbreaking METEOR trial was published in JAMA in late March amid little fanfare.
This study showed that rosuvastatin (Crestor), an emerging all-star on a team dominated by the sure Hall-of-Famer atorvastatin (Lipitor), stabilized plaque in the carotid arteries in patients with subclinical disease. And since carotid disease correlates directly to coronary disease, the implications of this study are clear: the drug kept portentous plaque from progressing before it made the patients sick.
In the interest of full disclosure, I will now admit that, although I have no clinical heart disease myself, I take a statin. This is because my father has heart disease, and my untreated LDL cholesterol hovers around 130. These circumstances are enough to convince me—and my own
internist—that a statin drug (along with an aspirin) will decrease my risk of ever having angina or a heart attack.
The METEOR trial and future studies with larger cohorts may prove beyond a doubt that I am right, but I am already sure of it, based on my clinical reasoning combined with the clinical trials conducted on sicker patients than myself.
Marc Siegel, MD, is an internist and associate professor of medicine at New York University and the author of False Alarm: The Truth About the Epidemic of Fear