Tuesday, January 1, 2019

Diabetes, Arterial Calcification and Statin Drugs by Jeffrey Dach MD

Diabetes, Arterial Calcification and Statin Drugs
 
George is a 54 year old diabetic on statin drug for coronary artery disease. Five years ago, George had an episode of chest pain, which prompted a cardiac cath, during which a stent was placed in the LAD (left anterior descending). Even though George’s total cholesterol has always been normal (200), George’s cardiologist placed him on simvastatin, a statin drug to lower his cholesterol.  However, George has been reading about statins and he wants to stop taking the drug. Above image showing calcified coronary arteries on CAT scan courtesy of Hecht 2015.

Apparently, George discovered that statin drugs are ineffective for primary prevention of heart disease in healthy people, nor do they reduce mortality from heart disease in selected populations such as women, the elderly, renal dialysis, and COPD patients. Statins do not reduce mortality in primary prevention studies (in healthy populations), and seem to have the best effects in secondary prevention, ie in patients with known heart disease.  George wants to know if he really needs the statin drug, and “is it OK to stop taking it?”

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Jeffrey Dach MD