Pictures in Practice - Fungal and Bacterial Infections
By Nerys Hairon
The benefits of statins in general practice are even greater than has been predicted by clinical trials, new research reveals.
The study of 89 practices, published early online in Heart, found use of statins cut deaths by 39 per cent in patients with ischaemic heart disease.
GP cardiovascular experts said the results were 'very impressive' and provided 'important confirmation' of the benefits of statins in real-life situations.
The researchers said the QOF review group should take into account their study as it considers proposals for paying GPs to assess patients' cardiovascular risk.
Current use of statins reduced risk of death by 47 per cent, falling only slightly to 39 per cent after adjusting for use of other medication, co-morbidity, smoking, BMI and deprivation.
The study, which compared 2,266 patients with ischaemic heart disease who died and 9,064 matched controls, identified a 'significant protective
effect' with simvastatin and atorvastatin, both of which
reduced deaths by 38 per cent.
The researchers said the benefits of statins extended to women, patients with diabetes and the elderly, and became
evident within two years of treatment.
Study leader Professor Julia Hippisley-Cox, professor of clinical epidemiology and general practice at the University of Nottingham, said: 'The benefits of statins found in randomised controlled trials extend to unselected community-based patients.
'The benefits can be demonstrated within the first two years of treatment and continue to accrue over time.
'Since patients in the community are likely to be at higher risk than those in trials, the potential benefits from statins are likely to be greater than expected.'
Dr John Ashcroft, CHD lead at Erewash PCT, said: 'People in trials are always self-selecting and are always at lower risk than other people. Thirty-nine per cent is very impressive. It's yet more evidence statins in the real world are associated with big reductions in morbidity and mortality, just as seen in trials.'
Dr Terry McCormack, chair of the Primary Care Cardiovascular Society, said: 'The statin study is important confirmation in a real-life situation that statins do work.'