There Is No Evidence for an Increase in Acute Coronary Syndromes After Short-Term Abrupt Discontinuation of Statins in Stable Cardiac Patients

Abstract

Background-For a variety of reasons, many patients abruptly discontinue statin therapy. The present analysis was conducted to determine whether the risk of cardiovascular outcomes increases after withdrawal of statin therapy in a stable cardiac population. Methods and Results-In the Treating to New Target (TNT) study, 2 doses of atorvastatin (10 and 80 mg once daily) are being used in a double-blind parallel-group design. Of the 18 468 patients screened for study participation, 16 619 entered a dietary lead-in/drug-washout period, and of these, 15 432 eligible participants began treatment with atorvastatin 10 mg/d on an open-label basis. Of the subjects who entered the dietary lead-in/drug-washout period, 57% were receiving prior statin therapy. During the 6-week drug-washout period, there were 24 primary events (defined as coronary heart disease death, nonfatal myocardial infarction, resuscitated cardiac arrest, and fatal or nonfatal stroke); throughout the subsequent 8-week open-label period, there were 31 primary events. This equated to monthly Kaplan-Meier event rates of 0.20% during washout and 0.26% in the open-label phase. Event rates were therefore similar during the 2 phases. Conclusions-The present analysis demonstrates that short-term discontinuation of statin therapy in stable cardiac patients apparently does not lead to a clinically important increased risk of acute coronary syndromes.

Switch to etravirine for HIV‐positive patients receiving statin treatment: a prospective study

“…In addition, we confirmed that statin interruption did not cause any Serious Adverse Event as expected from an earlier report [24], and no cardiovascular disease was observed during the 12-week study period. Our results confirm the observations from clinical trials comparing newer drugs with standard treatments including boosted PI.…”

Statins and Stroke

“…Moreover, the National Registry of Myocardial Infarction showed that withdrawal of statin therapy in the first 24 h of hospitalization for non-ST segment elevation myocardial infarction is associated with worse hospital outcome (Spencer et al, 2004b). In contrast, the Treating to New Target (TNT) Study Group found no evidence for an increase in acute coronary syndromes after short-term abrupt discontinuation of statins in stable cardiac patients (McGowan et al, 2004). Presently, there are no data available regarding statin withdrawal in stroke patients.…”

A novel type of familial hypercholesterolemia: Double heterozygous mutations in LDL receptor and LDL receptor adaptor protein 1 gene

“…been described the existence of the rebound effect after transient suspension of statin therapy [8], it is also reported that short-term suspension of statins is safe for at least patients with stable cardiovascular disease [9]. Complications related to this short-term suspension of lipid-lowering therapy have not been observed so far in our institute.…”