Meta-analysis challenges statin use in cardio treatment

Meta-analysis of data from 20 cardiovascular-therapy trials, including 4S and Jupiter, reveals that low levels of HDL-cholesterol remain a significant risk even while statin therapies are being used to treat elevated LDL-cholesterol levels. The findings disprove the popular notion among doctors that by lowering LDL cholesterol with a statin, such other factors as HDL cholesterol don't matter.

"That's not true," says senior investigator Richard Karas of the Tufts Medical Center. He and colleagues established median baseline and on-treatment HDL-cholesterol levels (45 and 48 mg/dL, respectively) from the 20 trials. The levels were similar among statin-treated patients and controls, according to Heartwire.

The researchers adjusted for LDL-cholesterol levels and age. They found that a 10-mg/dL decrease in HDL-cholesterol levels was associated with 7.1 more myocardial infarctions per 1000 patient-years in statin-treated patients versus 8.3 among healthy controls. The inverse association between HDL-cholesterol levels and MI did not differ statistically between the statin-treated and control patients, and similar results were observed with other cardiovascular disease outcomes.

- here's the article (registration required)