Study decodes who actually needs statin medication to lower cholesterol

A new study in the US aims to determine the best method to screen and evaluate patients who are at risk of developing coronary heart disease and which patients would benefit from taking a statin medication to lower cholesterol. 

A new approach by researchers at Intermountain Health in Salt Lake City to determining risk and selecting a statin is the use of the coronary artery calcium (CAC) score which is determined by taking a low-radiation dose image of the heart using computed tomography (CT) to look for calcium deposits in plaques in the heart’s coronary arteries.

“Our study is now fully enrolled with over 5,600 patients, and in this abstract for the American College of Cardiology, we wanted to look at baseline characteristics and differences in statin prescribing recommendations,” said Jeffrey L. Anderson MD, principal investigator of the study and distinguished clinical and cardiovascular research physician at Intermountain Health.

“The question is: Can we do a better job in selecting people who need a statin for primary coronary risk reduction by using the coronary artery calcium score, rather than just putting coronary risk factors into an equation – that is, is it more effective to use direct imaging evidence of plaque burden or a risk probability. That’s what we’re aiming to find out,” he said.

The new study was presented at the American College of Cardiology’s Annual Scientific Sessions meeting in Chicago on Saturday.

The results of scoring by their assigned risk assessment tool were sent in letters to their personal physicians, including whether a statin was recommended based on a high-risk score.

Patients in the two groups in the study were found to have very similar baseline characteristics. However, researchers found that the rate of statin medication recommendations were different.

The study is expected to conclude in early 2026, at which time a comparison of outcomes, including deaths, heart attacks, strokes, and revascularisations during up to 7 years, and an average of over four years, of follow-up will be made.

This is especially important considering that statins entail costs and can have side effects, including muscle aches and an increased risk of diabetes.

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