Doctors in the Republic have discovered that a drug used to lower cholesterol can also have a dramatic and beneficial effect on patients at risk from heart attacks and strokes, both a major cause of premature death.
Preliminary results from trials in Ireland and elsewhere suggest that the risk of heart attack can be reduced by as much as 30 per cent and of stroke by up to 25 per cent.
As a result of their findings, a large international drug trial being run from the Republic has been halted and all patients put on the drug.
The drug being tested was atorvastatin or statin but the results were so positive that doctors decided to stop. Some patients participating in the trial were taking a dummy or placebo drug. But because the trial results were so encouraging, the doctors decided to stop so that the placebo patients could also benefit from the actual drug.
The trial is known as ASCOT (Anglo-Scandinavian Cardiac Outcomes) trial and involves more than 10,000 patients, 500 of them from Ireland. It is the largest European trial yet conducted into the treatment of heart disease.
Each drug test of this kind has an independent safety group that monitors data coming from the trial.
The Data Safety Monitoring Board of ASCOT took the decision to halt the part of the trial involving atorvastatin, which is marketed under the trade name Lipitor. Another part of the ASCOT trial not connected with the drug will continue.
The trial's principal investigator in the Republic, Prof Eoin O'Brien, professor of cardiovascular pharmacology at the Royal College of Surgeons in Dublin and consultant cardiologist at Beaumont hospital, confirmed that all patients recruited by the hospital had been written to this week.
"We have informed them of the benefits of atorvastatin and advised them to continue taking their medication as prescribed," he said. All 500 people will be given individual medical appointments over the coming weeks so that those who have been on a dummy pill can be prescribed the active statin. Statin has been used for some time for the treatment of high cholesterol. The study tested its value as a way to reduce the risk of heart attacks and strokes.
Early results from the study found that patients with high blood pressure but low to normal cholesterol levels who were taking atorvastatin experienced a reduction in heart attacks of approximately 33 per cent. The incidence of stroke in the treated group dropped by 25 per cent.
The 500 Irish patients were aged between 40 and 79 and were recruited into the ASCOT trial by doctors at Beaumont hospital.
Cardiovascular disease, including heart attack and stroke, is a major killer in Ireland.
There were 9,500 people admitted to Irish hospitals with stroke in 2001 and of these 2,500 died. The stroke incidence is 375 cases per 100,000 of population, higher than most other EU states.
Over 11,900 people in Ireland died from diseases of the cardiovascular system in 2001. The death rate from heart attacks alone is 176 per 100,000 of population - double the EU average.
The patients in the statin trial come from the Republic, Britain and five Nordic countries.
All were selected as having increased risk of heart disease through high blood pressure, but all also had low cholesterol levels.
All of these will now be advised to take a 10 mg dose of atorvastatin daily.
Asked to comment on the implications of yesterday's announcement, Prof O'Brien said it suggested that the statin group of drugs have an effect which goes beyond their cholesterol-lowering properties.
"It looks as if statins have an effect on stabilising plaque which has formed within diseased blood vessels.
"We really have to give serious consideration to prescribing statins to all patients with known cardiovascular disease. The evidence is very strong, regardless of the person's cholesterol level," he said.