Monday, September 24, 2007

More statin may save lives after heart attack but so may red wine

red wine
A higher dose of lipid-lowering statin may save one in ninety-five lives after a heart attack, but the added benefit is in the same range as a daily glass of red wine.

Two studies about the benefit of a high (80 mg) compared to a standard or moderate (20-40 mg) daily dose of statin after a myocardial infarction have been pooled to assess the impact of statin dose on mortality. A total of eight thousand patients have been analyzed. It came out that ninety-five patients must be treated with aggressive instead of normal statin therapy for two years in order to prevent one death; the mortality rate dropped from 4.9 to 3.6 percent.

Same range of benefit ...

A similar drop in mortality has been found comparing abstainers with consumers of alcohol: With moderate alcohol consumption, mortality from all causes dropped from 6.3 to 3.4 percent. The types of drinks have not been separated in this study but there are reasons to assume that red wine is particularly beneficial.

In the statin studies, the therapy has been started after the heart attacks. In the alcohol study, the consumption one year prior to the heart attacks has been assessed. Therefore, the two studies are not directly comparable. But it is still interesting that they come to a nearly identical range of benefit.

We also must take into account that statin studies are funded by statin manufacturers, therefore we always should be suspicious about a possible bias towards a better outcome. The cited alcohol study has been funded partly by the National Institute on Alcohol Abuse and Alcoholism, thus any conflict of interest may be excluded.

... and same range of cost

The additional costs of intensive versus standard statin therapy have been estimated about 1.40 dollars per day. For this money you get a glass of good wine and much more pleasure than from swallowing a pill. Warning: I you have been prescribed a statin, never change taking it without consulting your physician.

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