Very low levels of low-density lipoprotein (LDL) cholesrerol, the so-called "bad" cholesterol, seem to be safe for heart patients who are taking statins, researchers report.
Patients who are taking high doses of statins can see their LDL cholesterol drop from more than 200 milligrams per deciliter (mg/dl) past a target goal of 70 to B0 mg/dL to as low as 40 mg/dL. Whether such low cholesterol levels are safe has been the subject of debate.
"'We looked at patients who got to ultralow [LDL] cholesterol levels, and wanted to make sure that was safe," says study coauthor Dr. Christopher P. Cannon, a cardiologist at Brigham and Women's Hospital in Boston.
"'We found that it was not only safe, but it was better to have your [LDL] cholesterol down in the range of 40 or 50 mg/dL than 70 or 80 mg/dl," Cannon says.
In their study, Cannon and his team collected data on 1,825 patients who had experienced a heart attack or unstable angina and were taking 80 mg of Lipitor daily.
After four months of therapy, LDL cholesterol dropped below 100 mg/dl for 91% of the patients. Of these, 11% saw their LDL cholesterol drop below 40 mg/dL, according to the report.
Compared with other groups, the patients who had cholesterol levels lower than40 mg/dL and those whose cholesterol was between 40 and 60 mg/dL had fewer heart attacks, strokes, cardiac death, chest pain and additional heart procedures, the researchers found.
Moreover, there were no significant differences in adverse side effects from statins, such as muscle or liver abnormalities or death.
'A Good Thing'
"We can feel comfortable using high-dose statins in all high-risk patients, even if their [LDL] cholesterol ends up at 40 mg/dL That's actually a good thing," Cannon says. "The message is that lower is better and safe."
Dr. Eric J. Topol, chairman of the department of cardiovascular medicine and chief academic officer at The Cleveland Clinic, believes that these results will lower current cholesterol goals. "I think this is an important direction of our therapy for the future-lowering the bar," he says. 'And this study helps, validating [statins'] remarkable safety."