To: Anthony Wong who wrote (1027 ) 11/11/1998 6:45:00 PM From: Anthony Wong Respond to of 1722
(Dow Jones) Study Finds Cholesterol Drugs May Help Some More Than Angioplasty November 11, 1998 3:49 PM By Raymond Hennessey, Staff Reporter DALLAS -(Dow Jones)- Some patients who are currently being treated with balloon angioplasty for their stable coronary artery disease may benefit more from aggressive drug treatment to reduce cholesterol, according to a study released Wednesday. The trial showed that, 18 months after the patients first reported symptoms, 87% of people given a high dosage of the drug Lipitor didn't need angioplasty or a bypass, or have a heart attack or die, said Dr. Bertram Pitt, professor of medicine at the University of Michigan. Lipitor is marketed jointly by Warner-Lambert Co. (WLA) and Pfizer Inc. (PFE). It belongs to a heavily competitive class of drugs known as "statins" which have been shown to dramatically reduce cholesterol. There was also a "borderline significant" reduction in the amount of time that the patients who later received surgical treatment needed it. Of the 350 people studied, all had been referred to surgeons for angioplasty. But Pitt instead treated some with 80 milligrams of Lipitor. Pitt said the study indicates that it may be more cost effective to give patients with only one or two instances of blood vessel disease an aggressive dose of Lipitor or another of the statin family of cholesterol-lowering drugs, instead of an angioplasty. But, that will take a philosophical shift on the part of interventional cardiologists who perform the angioplasties, Pitt said. For one thing, doctors tend to see these patients "and think they're going to fall over tomorrow" with their artery disease, Pitt said. But, in some cases, it will be cheaper and possbily more effective to use a drug therapy, he said. And interventional cardiologists will also have to make the lowering of cholesterol higher on their list of priorities. But drug treatment isn't right for all patients, with Pitt estimating that it would be effective in only about 20% to 25% of heart patients. "If you need an angioplasty, you should get one," he said. Drug therapy to raise the levels of HDL, or the so-called good cholesterol, may also help a subset of patients who have unusually low levels of both HDL and the LDL, or "bad" cholesterol, said Dr. Hanna Rubins, chief of general internal medicine at the V.A. Medical Center in Minneapolis. Using the generic gemfibrozil, which is sold by Parke Davis under the brand Lopid, on 2,500 men with heart disease, Rubins found there were 22% fewer heart attacks and 26% fewer strokes compared with men who didn't take the drug. The research shows that gemfibrozil is as effective for patients with low levels of good cholesterol as statins are for patients with high levels of the bad form, Rubins said. Like Pitt, Rubins said her data shows that some doctors may be inappropriately treating their patients and not paying enough attention to lowering cholesterol. -Raymond Hennessey; 201-938-5240; raymond.hennessey@cor.dowjones.com Copyright (c) 1998 Dow Jones & Company, Inc. All Rights Reserved. smartmoney.com