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Thursday, April 17, 2014 8:09:17 AM
Stop and think about it......that means on average 20 out of 18,000 middle aged patients all on low dose statins died each year; a little bit over one in a thousand. The biggest identifable difference between them and a similar group of Americans was their EPA/AA ratio...the LDL-C levels were similar. The risk in Americans was six times higher.
The REDUCE-IT trial is complicated by two factors. The first is the though the risk factors based on the selected population (cohort) is much higher than JELIS, and this favors the likelyhood of seeing benefits earlier in the trials, the REDUCE-IT patients are on higher doses of statins, and this has two significant effects. The first is statins probably exert whatever clinical benefit they provide by reducing systemic imflammation. One way to look at this is that statins could be considered "add ons" to EPA. We know at present that atherosclerosis is an inflammatory disease, and not a lipid disorder. Therefore the rational for any therapy should be directed toward reducing inflammation rather than lipids. The second statin effect concern is that statins tend to increase production of AA which counters the effects of EPA (V).
The realities are that science argument is very compelling, it is just not well known by clinicians, and it is being conviently ignored by the FDA. The chance of the statin cartel is behind alot of this is obvious.
":>)JL
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