Drug Combo May Benefit Heart-Disease Patients

Medicines for diabetes and cholesterol cut risk factors for heart attacks, study suggests

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HealthDay Reporter

MONDAY, Jan. 15, 2007 (HealthDay News) -- Nondiabetics with heart disease who take the diabetes drug pioglitazone (Actos) along with the cholesterol-lowering drug simvastatin (Zocor) appear to have a reduction in insulin resistance.

Perhaps more important, there also appears to be a lowering of C-reactive protein, a marker of inflammation and a possible warning sign for increased risk of heart attack and heart disease, German researchers report.

But at least one U.S. expert questioned the significance of the findings, which were published in the Jan. 23 issue of the Journal of the American College of Cardiology.

In the study, lead author Dr. Markolf Hanefeld, director of the Center for Clinical Studies at GWI-TU in Dresden, and colleagues randomly selected 125 people with heart disease, but who did not suffer from diabetes, to receive Actos alone, Zocor alone, or Actos plus Zocor.

The researchers then measured the levels of C-reactive protein and insulin resistance at the beginning and the end of the 12-week trial.

People taking the Actos/Zocor combination had significantly reduced levels of C-reactive protein, compared with those taking Actos or Zocor alone. Those on the combination treatment saw a reduction from 3.49 milligrams per milliliter to 2.06 milligrams per milliliter. And they also experienced a significant decrease in their insulin resistance, the researchers found.

"Although treatment with each drug in monotherapy significantly improved several risk markers for cardiovascular disease, only the combination of pioglitazone and simvastatin, with its synergistic effect, seemed to have full anti-inflammatory potency and impact on the whole risk profile of patients with cardiovascular disease," the researchers concluded.

But one U.S. expert said the findings had no immediate clinical significance and should not lead to changes in treatment until studies show whether or not the drug combination actually reduces the incidence of heart attacks among patients with heart disease.

"It's interesting but not very useful for patients yet," said Dr. Byron K. Lee, an assistant professor of medicine at the University of California, San Francisco School of Medicine.

"We know that C-reactive protein is a marker of inflammation and that those with high C-reactive protein are more likely to have adverse cardiovascular events," Lee said. "However, it is not clear if lowering C-reactive protein helps.

"Before we can start recommending the drug combination, we need to know that the drugs actually decrease clinically relevant outcomes like heart attack and strokes," he said.

More information

For more on heart disease and risk factors, visit the American Heart Association.

SOURCES: Byron K. Lee, M.D., assistant professor, medicine, University of California, San Francisco School of Medicine; Jan. 23, 2007, Journal of the American College of Cardiology

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