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How to identify individuals likely to benefit from the use of Statins.

July 11, 2008

Analysis of:8-Year-Olds on Statins? A New Plan Quickly Bites Back | www.nytimes.com

Widespread use of statins is likely to reduce the incidence of heart attacks and strokes and reduce the process responsible: atherosclerosis. Statins are expensive and selection of individuals and children at high to moderate risk should go beyond risk stratification by standard means and use more objective evidence of early asymptomatic atherosclerosis. Such a measure is carotid intima-media thickness (IMT), a measurement that has recently had much impact on statin utilization (Vytorin and Merk/Schering-Plough). This phenotypic marker is noninvasive and without risk. Novel risk factors such as c-Reactive Protein and even markers of inflammation are rarely seen to be abnormal in young age groups. Traditional risk factors only identify a proportion of those who are seeing early changes in the wall of their arteries. Looking directly at the wall of the artery makes more sense.

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