Statins, Baby Aspirin, and Inflammation
Oct 15, 2017
Dera Dr. Holodnly,
Pending the results of the REPRIEVE study, which might not be published for a few more years, are there any glimpses that a daily low dose statin (i.e. Atorsvastatin 10 mg) or a baby aspirin might lower chronic inflammation markers and CV risk in older HIVers (>50) without any other added indications for such therapy (normal lipid profile, UD? Looking forward to your input. Thanks in advance
Response from Dr. Holodniy
It's a great question without definitive answers currently and why the study needs to be done. The REPRIEVE study will examine whether pitavastatin or placebo results in decreased cardiac events in people who are on HIV meds and have no prior history of heart disease or diabetes. The theory behind the study is that the addition of a statin regardless of having cardiac disease risk factors or not will reduce inflammation and therefore the possibility of having a heart attack. We know that people who have risk factors should be taking a statin and/or baby aspirin, whether they have HIV infection or not. We know that with HIV treatment and resulting undetectable viral loads, that inflammatory markers in the blood do decrease compared to when there is detectable virus. Is that sufficient in those patients without risk factors to lower the risk of cardiac event, I don't know. In general, baby aspirin or low dose statins are well tolerated in HIV patients, so one could argue that risks of complications or drug interactions are low and one could theoretically benefit from the addition of these medications even without risk factors. But I think I need to have study data to change practice.
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