The front page of today s New York Times features an article by Duff Wilson about the FDA s approval of AstraZeneca s Crestor, a statin, for preventive use in patients who do not necessarily have high cholesterol.
Wilson s focus here is the potential downside of adding elevated CRP, which is an index of inflammation, to the criteria for treating with statins to reduce the risk of cardiovascular disease, says Dr. Ross. Crestor, like all other statins currently in use, has a very low incidence of side effects, most of which are mild, and the potential benefit is dramatic as far as reducing cardiovascular risk.
Still, as Wilson shows and as we often point out, there are different ways of presenting risk and risk reduction, so we have to be careful with units. Statins reduce the risk of a cardiovascular event by 45%, which sounds very impressive, but the absolute risk only goes down from 0.37% to 0.17%. Wilson notes that at $3.50 a pill, the cost of prescribing Crestor to 500 people for a year would be $638,000 to prevent one heart attack. So this is a valid discussion.