Local cardiologists responding to heart drug news

By Cynthia T. Pegram, Lynchburg News & Advance
Published: February 8, 2008

When news of disappointing early findings about two drugs treating heart disease hit the national media, it released a flood of phone calls to The Cardiovascular Group in Lynchburg.

“We have lots of people on these medications and we had hundreds of calls,” Dr. Thomas Nygaard said.

The surge came following recent news accounts that Vytorin, a two-drug combination, when compared to the use of another drug, Zocor, alone didn’t slow the process of atherosclerosis, an artery-clogging disease.

If the drugs didn’t work, heart patients wanted to stop taking them.

“The bottom line - don’t discontinue the medications,” Nygaard said Wednesday, speaking to about 200 people attending a public forum on the issue.

The forum was the first of a new plan of action by The Cardiovascular Group of Centra’s Stroobants Heart Center to respond to issues being discussed by the media that create concern for heart patients.

The early release of the ENHANCE trial data was made public by a press release by the drug company Merck and Schering-Plough Pharmaceuticals, and based on a study of 720 patients with an extreme form of high cholesterol.

However, three large long-term trials on the drugs are also underway, involving thousands of patients worldwide. Among them, Nygaard said, are patients from the Central Virginia area.

The Food and Drug Administration, in response to the early release on the ENHANCE trial data, said last week that it will evaluate the full report provided by the company when it is complete “and determine whether any further regulatory action is warranted” with regard to the drugs in the study “and also whether any changes to FDA’s current approach to drugs that lower LDL cholesterol are warranted.” LDL - Low Density Lipoprotein - is involved in cholesterol transport in the blood and high LDL levels are a risk factor for heart disease.

The American College of Cardiology also issued a statement, recommending that major clinical decisions not be made on the basis of the ENHANCE trials alone.

Heart disease is a leading cause of death and disability in the Lynchburg area, as it is in the nation.

During the forum, Nygaard noted the development and use of cholesterol lowering statin drugs in the 1980s has revolutionized treatment of heart disease in combination with diet, exercise, and weight control.

“There is data that patients who stop statins suddenly are at increased risk of heart attack, and we certainly don’t want our patient stopping these medications, and a lot of them have just on the basis of what they’ve read.”

He noted that some of the patients attending Wednesday’s forum don’t have cardiologists, don’t require the specialty, “but they have questions.”

However, he said, “I think that they need to be very cautious about what they read in the media when it is related to scientific and medical information - and should never stop their medications without seeing their physicians first when this sort of information becomes available.”

Heart patients can expect the opportunity to hear presentations and ask

questions.

“We’re trying to take these problems when they arise as an opportunity to sit down and educate our patients - in other words, a community forum,” Nygaard said.