Research conducted at Shaare Zedek Medical Center by Dr. Shimon Kolker and Professor Shmuel Gottlieb from the Department of Cardiology, analysed an extensive sampling of 6,790 patients who were registered between 2002-2010 in the national patient database which documents all occurrences of myocardial infarctions (heart attacks). The researchers compared patients that suffered from a complete blockage of the artery (according to their EKG) and required emergency catheterization to patients with partial blockage, and checked who among them took statins (medication for reducing cholesterol levels) on a regular basis before the infarction. They found that the group of patients that didn’t take statins suffered more severe heart attacks and a complete blockage. Those who took statins usually had milder heart attacks, didn’t require emergency catheterization and presented with smaller damage to the heart muscle.
“We try to prevent heart attacks all together, but if a patient still has one, obviously it’s better that the blockage be partial”, says Prof. Gottlieb. “In these cases there’s no need for emergency catheterization, the recovery is quicker and the damage to the muscle is smaller”.
Myocardial infarction is caused by a tear of sclerotic plaque in the wall of the coronary artery that supplies blood to the heart muscle. When sclerotic plaque is created, there is always a risk that it will burst and cause a blood clot to be created (to cover the tear). Statins stabilize the sclerotic plaque. The thicker the membrane surrounding the plaque, the smaller the risk of a tear. “In addition to reducing cholesterol levels in the blood and fats in the sclerotic plaque, statins also help improve blood clotting, reduce inflammations and more. Reducing LDL levels (the bad cholesterol) also reduces the risk of heart attack”, Prof. Gottlieb explains. “We also found that at any LDL level (even in the “safe” zone, i.e. below 70) the group of patients on statins had less blockage in their arteries in comparison to the group of patients that didn’t take statins”.
Based on their findings, the researchers recommend prescribing statins to all patients that are at risk of coronary heart disease: diabetics, people with a family history of heart disease, and of course people who already had a heart attack in the past. In addition, the researchers recommend reducing the LDL levels to 50 (up to now the recommended level was 70) to further reduce the risk of severe heart attacks.
“We are in the midst of a breakthrough multi-institutional research to examine the option to reduce cholesterol levels using a bi-weekly or monthly injection. The initial results are promising”, sums up Prof. Gottlieb.