Public Release: 

Minneapolis study finds most major heart attacks occur in people with normal cholesterol

New statin guidelines are more likely to treat these people before their heart attacks

Allina Health

MINNEAPOLIS - 04/12/2017 - For decades, national guidelines on which Americans should take cholesterol-lowering medications relied heavily on an individual's level of bad cholesterol (LDL). In 2013, new guidelines moved to treatment based on a person's overall heart attack risk.

"The data on statins clearly shows that individuals with normal cholesterol levels can also reduce their risk of heart attacks," said Michael Miedema, MD, MPH, cardiologist with Minneapolis Heart Institute® and principal investigator for a Minneapolis Heart Institute Foundation® study of the new guidelines.

However, the study found that more than half of the patients had not seen a physician in the two years prior to their heart attacks.

"The more recent cholesterol guidelines are clearly a big step in the right direction, but we need to have better systems and incentives in place to get patients the assessment and treatments that could potentially be life-saving," Miedema said.

When the more recent cholesterol guidelines were applied, the patients were twice as likely to be eligible for a statin prior to their heart attacks compared to the older guidelines that relied on cholesterol levels. Seventy-nine percent were statin eligible according to the newer guidelines, compared to 39 percent that qualified by the older guidelines.

"Heart disease is a multifactorial process, and factors others than cholesterol, like smoking or high blood pressure, can raise your risk even if your cholesterol is normal. In fact, we found that the average cholesterol levels in this group of individuals were quite average," Miedema said.

Minneapolis Heart Institute Foundation researchers analyzed risk factor data, cholesterol values, and prior medical encounters in 1,062 patients who were treated for STEMI heart attacks between January 1, 2011 and December 31, 2014 as part of Minneapolis Heart Institute® regional STEMI program. A STEMI, or ST-Elevation Myocardial Infarction, is one of the most serious cardiovascular events, as it can frequently lead to severe damage to the heart and even cardiac arrest.

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"Statin Eligibility and Outpatient Care Prior to ST-Elevation Myocardial Infection" will be published April 12 in the American Heart Association's peer-reviewed Journal of the American Heart Association. The study was funded by the Minneapolis Heart Institute Foundation.

About the Minneapolis Heart Institute Foundation®

The Minneapolis Heart Institute Foundation (MHIF) strives to create a world without heart and vascular disease. To achieve this bold vision, it is dedicated to improving the cardiovascular health of individuals and communities through innovative research and education.

Scientific Innovation and Research -- MHIF is a recognized research leader in the broadest range of cardiovascular medicine and population health initiatives. Each year MHIF leads more than 175 active research projects and publishes more than 175 peer-reviewed abstracts. Cardiologists, hospitals and communities around the world adopt MHIF protocols to save lives, improve care and create healthier living opportunities.

Education and Outreach -- MHIF provides more than 10,000 hours of education each year putting its research into practice to improve outcomes. And, MHIF leads cutting-edge, transformative population health research to connect, engage, inform and empower individuals and communities to improve their health.

The Minneapolis Heart Institute Foundation's work is funded by generous donors and sponsors and supports research initiatives of Minneapolis Heart Institute® at Abbott Northwestern Hospital.

Minneapolis Heart Institute® physicians provide care for patients at Abbott Northwestern Hospital in Minneapolis and at 38 community sites across Minnesota and western Wisconsin.

Minneapolis Heart Institute® and Abbott Northwestern Hospital are part of Allina Health.

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