Stories tagged cardiovascular

Nov
09
2008

Crestor: :Rosuvastatin
Crestor: :RosuvastatinCourtesy Mykhal
The drug company, AstraZenca, makes a drug called Crestor and also receives royalties from a particular blood test (hsCRP) which detects C-reactive protein (CRP), an indicator of infection.

AstraZenca funded a study which found that their product, Crestor, when given to patients identified as having infection via their blood test (hsCRP), "slashed the risk (of heart attack or stroke) of those flagged by the test by about half -- even if their cholesterol was normal".

Infection's role in cardiovascular risk

Why people with normal cholesterol levels suffered heart attacks or strokes has been puzzling. In the study,

either 20 milligrams of the statin Crestor or an inert placebo (was given) daily to 17,802 middle-aged and elderly men and women who had what are considered safe cholesterol levels but high CRP -- 2 milligrams per liter of blood or above.
(They)stopped the trial ... after an average follow-up of less than two years, concluding that the benefit was so striking that it would unethical to continue withholding the real drug from those taking the placebo.
Compared with those getting the placebo, those taking Crestor were 54 percent less likely to have a heart attack, 48 percent less to have a stroke, 46 percent less likely to need angioplasty or bypass surgery to open a clogged artery, 44 percent less likely to suffer any of those events and 20 percent less likely to die from any cause, the researchers reported yesterday. WashingtonPost

Costs, benefits, and alternatives

For every 1000 people in this study who took Crestor, there were about 2 who had heart attacks compared to about 4 in the placebo group (per year).

Some skeptics, however, argued that the actual risk reduction for an individual would be very small, given the relatively low risk for most middle-aged people, so the benefits easily could be outweighed by the costs of thousands more people taking tests and drugs and being monitored by doctors.

The risks from extended use of Crestor by millions of patients is unknown. We do know that lifestyle interventions are effective.

Join the discussion, learn more

Washington Post Staff Writer Rob Stein will be online Monday, Nov. 10 at 11 a.m. ET to discuss a new study that could transform efforts to prevent heart attacks and strokes. You can discuss whether you think drugs and money or lifestyle changes are best for our future there or in comments below.

Read the research paper: Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein

A recent study in Poland showed that a flu shot can significantly reduce the risk of death for people with coronary artery disease. Dr. Arnold Monto, professor of epidemiology at the University of Michigan, said,

"We know that people die of flu who have underlying cardiopulmonary disease. It's only logical that if you are able to prevent flu with vaccine, you can prevent these deaths."

Mar
09
2005

A new study published in The New England Journal of Medicine shows that low doses of aspirin do not prevent first heart attacks in women under 65, as they do in men.

Earlier research, which focused mostly or entirely on men, indicated that aspirin prevents heart attacks. But the 10-year Women's Health Study, which followed 40,000 women, showed that aspirin does not prevent heart attacks in women. However, it does prevent strokes caused by blood clots, a benefit that has not been conclusively proven in men.

Women in the control group had the same number of heart attacks as the women in the aspirin group. But the number of strokes in the aspirin group was 17% lower. And the aspirin takers had a whopping 24% lower risk of ischemic stroke—the most common kind, caused by a blood clot in an artery leading to the brain. However, the risk of hemorrhagic stroke—caused by bleeding—was slightly higher in the aspirin group. (This was expected, because aspirin reduces blood's ability to clot.)

Both ischemic strokes and heart attacks are caused by blood clots in arteries, so it isn't clear why aspirin only protects women against strokes. The explanation may have something to do with the size of the blood vessels that lead to the brain, which are smaller than those leading to the heart, but no one knows yet for sure.

Because aspirin therapy increases the risk of bleeding, doctors don't currently advise men or women with no risk of heart disease to take aspirin as a preventive measure. Women with risk factors for heart disease (they're over 65, they smoke, have high blood pressure, are diabetic, or have a family history of cardiovascular problems) are often told to take a baby aspirin every day. That probably won't change.

But now doctors can fine-tune the way they manage patients with cardiovascular risk, knowing that women under 65 are more vulnerable to certain kinds of stroke.

You can read the New York Times article about the study here

You can read an abstract of the article in The New England Journal of Medicine here

What do you think about research that shows that some drugs affect women differently than men? Should drug studies have to include equal numbers of men and women? Or should they look at men and women separately? How about different ethnic groups? Or children?