Swift Statin Therapy Cuts In-Hospital Heart Attack Deaths

Treatment in first 24 hours saves lives

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By Ed Edelson
HealthDay Reporter

MONDAY, Aug. 29, 2005 (HealthDay News) -- Patients who get a statin drug in the critical first hours after a heart attack are much more likely to leave the hospital alive than those who don't get the cholesterol-lowering medication, new research finds.

Previous studies have shown that giving statins during a hospital stay for a heart attack reduces the long-term death rate. This one -- the largest of its kind ever done -- shows that the timing of the drug administration plays a significant role, said study author Dr. Gregg C. Fonarow, a cardiology professor at the University of California at Los Angeles (UCLA), His report appears in the Sept. 1 issue of the American Journal of Cardiology.

"The current guidelines say that statin therapy should start before hospital discharge," Fonarow said. "This study indicates that it should be started at once, just as aspirin therapy is done."

The study looked at data on more than 170,000 records in a national database of people admitted to hospitals because of heart attacks. It found that the people who had been taking statins before going to the hospital and were given the drugs within 24 hours after admission had a 54 percent lower risk of dying in the hospital.

Patients who had not been taking a statin but were started on the therapy within 24 hours of hospital admission were 58 percent less likely to die in the hospital than those not taking the drugs.

"There was not only less mortality, but also fewer complications such as severe arrhythmias and shock," Fonarow said. "This is a truly new and very important clinical finding."

Statins produce their benefits by increasing the level of nitric oxide, which reduces inflammation and helps widen arteries, he explained.

Although the study was not a controlled trial, the gold standard in medical research, "it may lead to a recommendation for changes in the guidelines," he said.

Such changes have already been instituted at UCLA, Fonarow added. Heart attack patients are started on statin therapy in the emergency department, along with aspirin and other recommended drugs, he said.

The same is true at the Mayo Clinic, said Dr. R. Scott Wright, a cardiologist who took part in the study.

"The evidence isn't 100 percent certain, but we think the preponderance of it is such that we have put these drugs on our acute myocardial infarction order set," the list of "musts" for heart attack patients, he said.

And while the current report deals only with survival in the hospital, analysis of the data from the study, published in a different journal, "shows enhanced long-term survival," Wright said. "The benefits of the therapy carry on for several years beyond discharge."

More information

The symptoms of a heart attack and what should be done about it are described by the American Heart Association.

SOURCES: Gregg C. Fonarow, M.D., professor, cardiology, University of California at Los Angeles; R. Scott Wright, M.D., cardiologist, Mayo Clinic, Rochester, Minn.; Sept. 1, 2005, American Journal of Cardiology

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