Statins increase the risk of angina by 15% in patients receiving angioplasty treatment

This study was published in Heart 2004 Apr;90(4):448-9

 

Study title and authors:

Effect of statin treatment on coronary collateral flow in patients with coronary artery disease.

Zbinden S, Brunner N, Wustmann K, Billinger M, Meier B, Seiler C.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/15020529

 

Collateral blood vessels are small capillary-like branches of an artery that form over time in response to narrowed coronary arteries. The collaterals "bypass" the area of narrowing and help to restore blood flow.

 

A coronary angioplasty is a procedure used to widen blocked or narrowed coronary arteries. A short wire-mesh tube, called a stent, is inserted into an artery to allow blood to flow more freely through it.

A balloon occlusion test is a way to see whether one artery can be temporarily or permanently blocked without significantly affecting the level of blood in your brain. The procedure utilizes an X-ray and a special dye to create detailed images of your arteries and a small balloon, which when inflated will temporarily block your artery.

 

This study investigated the influence of statins on the formation of collateral arteries in patients with coronary artery disease undergoing coronary angioplasty. The study included 500 patients who had their collateral blood vessels assessed whilst undergoing angioplasty.

 

The study found:

(a) Measurement by electrocardiogram revealed patients taking statins had a 14% increased risk of insufficient collateral arteries compared to patients not taking statins.

(b) Patients taking statins had a 15% increased risk of suffering angina during a balloon occlusion test compared to patients not taking statins.

Statin use is associated with an increased risk of adverse events in patients undergoing coronary artery bypass surgery for unstable angina

This study was published in the European Journal of Cardiothoracic Surgery 2005 Jun;27(6):1051-6

Study title and authors:
Preoperative statin use and in-hospital outcomes following heart surgery in patients with unstable angina.

Ali IS, Buth KJ.
Division of Cardiac Surgery, Dalhousie University, Halifax, NS, Canada. imtiaz.ali@dal.ca

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/15896616

Unstable angina happens when blood flow to the heart is suddenly slowed by narrowed vessels or small blood clots that form in the coronary arteries. Unstable angina is a warning sign that a heart attack may soon occur. It is an emergency. It may happen at rest or with light activity.

This study investigated the effects of preoperative statin use in patients with unstable angina undergoing coronary artery bypass graft / valve surgery. The study matched 534 patients taking statins with 534 patients not on statins from 1,706 patients classified with Canadian Cardiovascular Society Angina Grading IV (the most severe grade of angina).

In this study composite outcome refers to adverse events namely: dying in hospital, needing intra-aortic balloon pump use, heart attack, needing use of a ventilator and stroke.

The study found:
(a) Patients taking statins had a 10% increased risk of death whilst in hospital compared to patients not taking statins.
(b) Patients taking statins had a 14% increased risk of composite outcomes compared to patients not taking statins.