Lancet Study Emphasizes Long Term Benefit and Safety of Statin Use

Richard Bulbulia, MD, of the Heart Protection Study Group reported in the Lancet that statin medications are safe and effective over long periods of time.  They looked at 20,536 patients at high risk for vascular events. They studied patients who were between 40 and 80 years old. These patients were randomized to one group receiving Simvastatin (Zocor) daily at the 40 mg dose or placebo for 5.3 years. They were then followed for another six years during which both groups received the statin.

Researchers found that during the initial 5.3 years of the study there was a 23% decrease in major vascular events and an 18% reduction in vascular mortality in the Simvastatin treated group.

They also looked at complications of therapy over the eleven year period and concluded, “Reassuringly, there was no evidence that any adverse effect on particular causes of non–vascular mortality or major morbidity, including site-specific cancer, was emerging during this prolonged follow-up period.”  In an editorial in the same edition, Payal Kohli, MD and Christopher Cannon, MD of the Brigham and Women’s Hospital in Boston said the results “provide contemporary and confirmatory evidence that extended use of statins is safe with respect to possible risk of cancer and non-vascular mortality.”

It is noted that the dosages used are higher than what the FDA currently recommends for Simvastatin due to the risk of muscle injury at higher doses. Despite that, the Lancet editorialists concluded that “concerns should be put to rest and doctors should feel reassured about the long-term safety of this life saving treatment for patients at increased cardiovascular risk.”

A Treasure Lost – Surgeon, David Wulkan, M.D.

I lost a colleague this week to acute leukemia. He was diagnosed and treated at a world class Center of Excellence but succumbed to the complications of treatment so rapidly that those of us who worked with him daily had little knowledge that he was ill or gone until it was all over.  This 56 year old General and Vascular surgeon shared a February 17th birthday with me, came from a working class urban background and trained in the General Surgery program at the rigorous and demanding University of Miami Jackson Memorial Hospital Program. He completed his residency training several years after I completed my general medical training and then moved up to Boca Raton, Florida to join one of the premier surgical groups in the area.

My wife had the privilege of teaching one of his children at the pre-school level and knew his wife and children. We never broke bread together or visited each other in our respective homes. We didn’t go out socially together either. Despite this, I considered him a friend as I saw him on a daily basis while I made morning and evening rounds at the Boca Raton Community Hospital as we both strove to prevent disease and help others. He was warm, understanding, even-tempered, showed great judgment clinically and great understanding of his patients’ needs and concerns.

Surgeons are often branded as arrogant, cold, and volatile. Dave was like a teddy bear, just a very bright talented competent one.  We shared patients and they all thanked me for finding them such a special physician in their time of need. He educated me when I needed to be educated and he did it in a manner that conveyed the message in a professional and respectful way without making me feel like I should have known that.

I know the kind of hours he put in and the sacrifices his wife and children made with regard to time so that he could care for other persons’ loved ones. That is time one never recaptures.

My community has lost a treasure of a doctor and a wonderful human being. We will miss his kind and affable manner, wisdom and skill. My thoughts and prayers will be with him and his family and with the families of all those other caregivers who make it easier for their loved one to care for and help someone else’s loved one routinely.

I was proud to be Dr. Wulkan’s colleague and will miss him greatly.