Coronary artery bypass graft surgery. (iStock)
People taking statins for heart disease saw major benefits when doctors added a powerful, newer drug to their treatment regimen, according to a major study released Friday morning at the start of an American College of Cardiology conference in Washington.
The addition of the cholesterol-busting drug evolocumab, from a class known as PCSK9 inhibitors, reduced the risk of deaths, heart attacks, strokes, the need for coronary bypass and hospitalization for chest pain, according to a team of researchers from around the globe, who also published their results online Friday in the New England Journal of Medicine.
Evolocumab works by lowering LDL, or “bad,” cholesterol. The researchers found an average decline of 59 percent in LDL levels among the 14,000 people in 49 countries who were put on the drug for 48 weeks, when compared with an almost identical number of patients who received a placebo.
And when the researchers looked at the most serious possible outcomes for heart patients — deaths, heart attacks and strokes — the study showed a 20 percent reduction of those events.
“The data from our trial provide insight into the benefit of decreasing LDL cholesterol levels to median levels lower than those in previous trials,” wrote the researchers, led by Marc S. Sabatine of Brigham and Women’s Hospital in Boston.
The data reinforce the growing body of evidence showing that as clinicians push LDL cholesterol levels ever lower, their patients fare better. Currently, an LDL cholesterol below 100 is considered optimal for people at risk of heart disease, according to the Mayo clinic.
Heart disease is the number one killer of Americans.
A second study of another PCSK9 inhibitor, bococizumab, was much less successful and was terminated, another set of researchers reported Friday. It showed widely varying effects on LDL cholesterol levels and had no benefit for people with LDL levels below 100, although patients with higher LDL levels did see significant benefits. In contrast to evolocumab, the impact seemed to fade with time and some patients developed antibodies to the drug.
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