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Cholesterol Drugs Lessen Surgery Risks

November 11, 2005|Thomas H. Maugh II | Times Staff Writer

The risk of stroke or death following the most commonly performed stroke-prevention surgery is sharply reduced if patients receive cholesterollowering drugs called statins before the operation, researchers said Thursday.

As many as 180,000 Americans undergo carotid endarterectomies each year to remove or stabilize plaque in neck arteries that would otherwise break off and trigger strokes, but the operation can occasionally cause a stroke.

If the patients have been receiving statins, the risk of stroke immediately after the surgery is reduced by about 70%, and the risk of death drops by 80%, researchers from Johns Hopkins University reported at a news conference sponsored by the American Medical Assn. The report is being published in the Journal of Vascular Surgery.

Dr. Fred A. Weaver, chief of vascular surgery at USC's Keck School of Medicine, said although the finding was intriguing, it would not drastically change surgical practices because most patients at risk for stroke were already taking statins.

Added Dr. Patrick Lamparello of New York University School of Medicine: "We're seeing more and more evidence that these drugs probably ought to be used in various types of surgery -- that giving statins may in fact improve your outcome."

The benefits for the surgery are probably independent of the drugs' cholesterol-lowering effects, said Dr. Bruce A. Perler of Johns Hopkins, who led the study. The drugs have also been shown to induce blood vessels to dilate, reduce inflammation, stabilize plaque and protect brain cells.

"Statins may be the penicillin of the 21st century," Perler said. "They almost seem to be a miracle drug."

Statins, introduced in the 1990s, are used by millions of Americans -- particularly those with risk factors for heart disease -- because of their proven benefit in lowering the chances of having a heart attack or a stroke.

Perler and his colleagues studied 1,566 patients who underwent carotid endarterectomies performed by 15 surgeons at Johns Hopkins.

Of the patients in the study, 42% had been taking a statin for at least a week. Experts say the percentage was low because the data was collected over 10 years. Now, Weaver said, at least 70% of patients would be receiving the drug, perhaps more.

About 4.5% of the patients not receiving statins suffered a stroke, compared with 1.2% of those on the drug. About 2.1% of those not receiving statins died, compared with 0.3% of those on the drug.

"These data say we can make a safe operation even safer," Perler said.

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