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Tuesday, 5 March, 2002, 00:09 GMT
Hospital 'drug break' could be fatal
Patients should still be taking the tablets, say doctors
Heart patients who stop taking their tablets while they are in hospital are increasing the risk of sudden death, say researchers.

While most doctors try to make sure that patients in hospital after a heart attack or severe angina episode keep taking the same medication, there are some whose drugs are interrupted.

Researchers from Kerckhoff Heart Center in Germany, alongside the University of Hamburg, looked at 465 patients who had been on a course of "statin" drugs before being admitted to hospital with chest pain.

These drugs aim to reduce the level of cholesterol in the bloodstream, reducing the chance of either angina or a heart attack.

This just reinforces the message to patients that if they are not getting their statins in hospital, they should ask the doctor why

Dr Peter Jackson, University of Sheffield
Most of the patients carried on getting their statins even after they reached hospital - however, in 86 cases the drugs were discontinued.

After 30 days, the researchers looked to see how each group had progressed.

Those who had not carried on taking the drugs after hospitalisation were almost three times more likely than the others to have died.

Dr Christian Hamm, who led the study, said: "The message to physicians is: Don't stop statins.

"Withdrawal of statin therapy shortly after the onset of symptoms completely eliminated the protective effect of statins in coronary heart disease patients hospitalised with severe chest pain.

"The increase in deaths and acute heart attacks was only explained by the statin withdrawal."

Multiple role

He said that the drugs did more than just reduce cholesterol levels, reducing inflammation in the arteries, and the ability of a certain component of blood to clump together and form dangerous clots which could lead to a heart attack.

UK consultant clinical pharmacologist Dr Peter Jackson said that studies had suggested a significant benefit for patients put on statins in the days following heart attack or angina episode.

This, he said, would make him expect to see patients fare less well without statins - although perhaps not to such a pronounced degree.

'Uncommon lapses'

He said that while most patients in this situation did get the right medication while in hospital, there was the potential for occasional "lapses".

"This just reinforces the message to patients that if they are not getting their statins in hospital, they should ask the doctor why.

"The patient is one of the safety mechanisms making sure they continue to receive this kind of treatment while they are in hospital."

The study was published in the journal Circulation.

See also:

13 Nov 01 | Health
Heart drugs could save thousands
13 Nov 01 | Health
Q&A: Heart drugs study
05 Apr 01 | Health
Heart care 'biased against women'
23 Jun 00 | G-I
Risk factors and prevention
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