Patients with a high genetic risk of heart attack benefit more from statin therapy than those in intermediate and low-risk categories, according to research published in The Lancet. Although past research consistently showed that statins provide about the same relative risk reduction across all categories of patients, the researchers did find a difference in the effect of statin therapy by looking specifically at genetic risk factors.
While more statins are being prescribed, there is an ongoing debate about whether these drugs are being overused. To look specifically at the role of genetic factors, Nathan O. Stitziel and colleagues combined the data of 49,000 people enrolled in five studies. The researchers assessed the risk of heart attack independently of traditional risk factors such as age, sex, cholesterol levels and diabetes.
Individuals in the high-risk category had a 70 percent higher risk of heart attacks compared with those at lowest genetic risk. Statin therapy resulted in a 13 percent reduction in risk in the low-risk group, a 29 percent reduction in the intermediate group and a 48 percent reduction in the high-risk group. According to Stitziel, the new results differ from previous research that consistently has shown statins provide about the same relative risk reduction: 30 to 45 percent (depending on dose) across all categories of patients.
"Some have said we should be treating more people with statins, while others say we need to treat fewer”, says Stitziel. “As an example of precision medicine, yet another approach is to identify people at high risk and preferentially prescribe statin therapy to those individuals. Genetics appears to be one way to identify high-risk patients." This type of genetic analysis is not available to patients right now, but when more research validates the findings, such a test could be developed for clinical use.
Sources: The Lancet and Eurekalert
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