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20 years evidence confirms benefit of statins for reduced coronary mortality

Results from a study published in the journal Atherosclerosis confirm benefit of statins in reducing coronary heart disease (CHD) mortality. Evidence between 1980 and 2016 suggested that risk for fatal coronary disease has continued to fall with treatment in men with familial hypercholesterolaemia (FH), but women with FH may not be receiving adequate treatment.

1903 patients with definite FH and 1650 with possible FH from 21 lipid clinics across the United Kingdom were recruited. All patients were prospectively followed for 67,760 person-years. Mortality was analysed for period before 1992 (when statins were not used routinely), between 1992 and 2008 (statin treatment widely available) and between 2009 and 2015 (high potency statin treatment used with/without other lipid-lowering agents).

In men with treated definite FH and previous CHD, coronary mortality declined by 48% from pre-statin period in 1991 to latest period post-statin introduction. Contrastingly in women, coronary mortality was similar in periods before and after introduction of statins. In men with treated definite FH and no previous CHD, the excess coronary mortality fell by 55% over 3 time periods and was not significantly elevated post-2008, but in women it remained significantly elevated.

Authors question if females with definite FH were treated as vigorously as their male counterparts. Despite of UK and European guidelines recommending potent statins to lower low-density lipoprotein-cholesterol, inadequate treatment in patients with FH and pre-existing CHD, particularly women, is a matter of concern.


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