ANN ARBOR, Mich. -- When it comes to cholesterol-lowering drugs, more is better. At least, thats what heart doctors and heart patients have been hearing in recent years. And as a result, more patients are taking higher doses of drugs called statins leading to lower heart and stroke risk, but higher prescription drug costs and more frequent side effects.
Now, a new study looks at whether those higher doses, and higher costs, are really going to pay off for some patients. For those with a recent heart attack or what doctors call acute coronary syndrome, the answer is yes, the researchers say.
But the picture is less clear for those patients with known heart blockages who have stable symptoms. For them, the usual dose of their statin may provide adequate heart-protecting benefit, and the higher cost of high-dose statins may provide only marginal benefit at much greater cost, especially if they use generic statins.
The study, from a team at the University of Michigan Cardiovascular Center and the VA Ann Arbor Healthcare System, is published online in the journal Circulation, and will be in the May 8 print issue of the journal. Its based on a sophisticated computer analysis of data from thousands of patients.
The team finds that patients with a recent history of acute coronary syndrome (ACS) either a heart attack or hospital stay for chest pain get so much benefit from higher doses of statins (over four additional quality-adjusted months of life) that the extra cost of the increased dose is worthwhile, even if the difference is a few dollars a day.
But for patients with stable coronary artery disease (CAD), whose arteries have been narrowed by plaque but who havent had a recent heart attack or hospitalization for chest pain, the much smaller gain (about 5 weeks of quality-adjusted life) from a higher dose of a statin may not be sufficient to outweigh the extra cost.