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http://www.nytimes.com/2002/07/02/health/02TREA.html

Treatments: A Caveat to Cholesterol Drugs

By ERIC NAGOURNEY

esearchers have confirmed that cholesterol-lowering drugs, or statins, reduce the risk of later heart attacks in cardiac patients. But the researchers warned that the drugs might pose risks if given to people whose cholesterol levels were relatively low to begin with.

The study, which appeared in The Journal of the American Medical Association, endorses the current practice of prescribing statins to heart attack patients whose "bad cholesterol," or L.D.L., readings are 130 or higher.

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The lead author, Dr. L. Kristin Newby of Duke University and her colleagues wanted to see whether statins would be more beneficial if they were prescribed when the patients were still in hospitals, rather than after they were released.

In the course of the study, the researchers reported, they found no harm in introducing the drugs earlier and suggested that it be considered.

But they did find that patients who were given the drugs shortly after heart attacks, even though their cholesterol levels were below 130, appeared to have increased rates of death and later heart attacks. The researchers recommended a broader study. Until then, they wrote, "clinicians should use caution in starting statin therapy" for these patients.

The authors based their findings on data gathered in two international drug trials involving more than 15,000 patients.

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