Drugs commonly taken for primary cardiovascular prevention, such as statins and aspirin, can also reduce the severity of myocardial infarction, according to Chinese research.
A large observational study involving nearly 15,000 patients provides further evidence of the benefit of such medications, said the researchers the online journal PLOS ONE.
The findings follow a recent review, published in the Lancet, suggesting the benefits of statin therapy had been repeatedly underestimated and the harms exaggerated.
The new study will be presented at the Great Wall International Congress of Cardiology, being held from 13-16 October 2016 in Beijing.
It assessed the relationship between prior use of four preventive medications – antiplatelet agents such as aspirin, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, statins, and beta-blockers – and hospital outcomes in patients with acute coronary syndromes, such as myocardial infarction or unstable angina.
The research included 14,790 patients admitted for acute coronary syndromes in 75 hospitals participating in the Clinical Pathways for Acute Coronary Syndromes—Phase 2 (CPACS-2) Study.
Among the patients, around half had a history of cardiovascular disease and were included in the study with a secondary event, while the remainder entered it with a first event.
“Our findings suggest that the benefits of these medications may extend beyond preventing acute coronary syndromes”
The researchers assessed the association between prior medication use and in-hospital outcomes including severity of disease, arrhythmias, and major adverse cardiovascular events – death, non-fatal myocardial infarction or re-infarction, and non-fatal stroke.
They also did a sub-group analysis based on whether or not patients had prior established CVD to reveal whether the effect of medication on outcomes differed between first and repeat events.
Prior use of each drug was significantly linked with less severity of disease, less arrhythmia, and reduced risk of adverse events. The findings were similar in those with or without a history of CVD.
Compared to those taking none of the medications, patients taking either one, two, three or all four of the drugs had a 23%, 33%, 52% and 41% reduced risk of an adverse event, respectively.
The same trend was observed for severity of disease and occurrence of arrhythmias. Similar findings were observed in patients with and without a history of CVD.
Lead author Dr Min Li, from Peking University Health Science Centre, said: “Until now it was not known whether these drugs provided any benefit to patients who develop a heart attack despite taking the medication.”
She said: “Our findings suggest that the benefits of these medications may extend beyond preventing acute coronary syndromes. They may also reduce the severity of disease, and in-hospital adverse outcomes.”
She urged patients to continue taking the drugs long-term when advised to do so and said those who still had a cardiovascular event while using them should not lose confidence “because they do help”.
Dr Michael Knapton
Dr Mike Knapton, associate medical director at the British Heart Foundation, said: “This large observational study suggests that taking these drugs could actually go one step further [than primary prevention], and reduce the severity of a heart attack, and the development of abnormal heart rhythms and the risk of suffering a fatal cardiac event.
“It is extremely encouraging that this evidence suggests these commonly prescribed medicines can also reduce the severity of any subsequent heart attack,” he said.
“The findings reiterate the importance of people being recommended optimal treatment, and patients taking their prescribed medication,” said Dr Knapton.
Professor Michel Komajda, a past president of the European Society for Cardiology, added: “We need to do more to encourage adherence, and to help patients adopt healthy lifestyle behaviours.”