CLEVELAND, OH – Heart disease is the leading cause of death in the US. More than a quarter of Americans over the age of 40 are taking a statin to lower their cholesterol and to lower their risk of heart attack and stroke. In fact, statins are one of the most prescribed drugs in the country.
But what happens if you are statin-intolerant? It turns out, there’s other help for your heart.
“Statins are marvelous drugs. They have probably saved as many lives as any drugs we’ve ever developed,” said Dr. Steven E. Nissen, Chief Academic Officer of the Heart Vascular & Thoracic Institute at Cleveland Clinic said.
If someone has high levels of LDL cholesterol, known as “the bad” cholesterol, it can build up in the walls of blood vessels and create blockages. Statins are the first line of defense to lower those levels. But Nissen said that up to 15% of the people who need statins experience debilitating muscle pain when they take them.
“At some point, they will come to us and they will say, ‘I just can’t take these drugs. I don’t feel well enough when I take them,” Nissen said.
Alternatives include ezetimibe, but it’s only effective in some people. PCSK9 inhibitors are powerful but need to be injected every couple of weeks. Now a Cleveland Clinic-led clinical trial found that the use of bempedoic acid reduced adverse cardiovascular outcomes in 14 thousand statin-intolerant people.
“For some of these people who just desperately need to have their LDL cholesterol treated, yes, it can be really an important drug,” Nissen explained.
After six months, bempedoic acid reduced LDL cholesterol by 23% and reduced inflammation by 22%. There was also a 30% reduction in major cardiovascular events and a 39% decline in heart attacks.
“It’s another reason why we believe that you ought to treat early, and you ought to treat intensively,” Nissen said.
Nissen said side effects from bempedoic include a slightly higher risk for gout and gallstones.