ACC.17: EBBINGHAUS trial shows statins don’t affect cognitive ability

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 - Robert Giugliano

Findings presented at the American College of Cardiology’s 66th Annual Scientific Session show that adding a cholesterol-lowering drug to treatment with a statin has no effect on cognition and thinking.

The results were presented by Robert Giugliano, MD, an associate professor at Harvard Medical School and a physician at Brigham and Women’s Hospital in Boston, who conducted the trial called EBBINGHAUS. It was funded by Amgen, a biotechnology company based out of Thousand Oaks, California.

Though other research has suggested a link between statins and memory difficulties in patients, Giugliano’s study breaks down some of those theories and suggests that statins and proprotein convertase subtilisin-kexin 9 (PCSK9) inhibitors don’t deprive the brain of cholesterol.

“Ours is the first prospectively designed study to evaluate the relationship between a PCSK9 inhibitor and changes in cognition, including memory, attention and reaction time,” Giugliano said. “Our findings are reassuring in that we found no apparent effect on any of these cognitive domains despite achieving very low blood levels of LDL cholesterol.”

The study included nearly 2,000 patients who were also participating in the FOURIER trial, a double-blind randomized trial conducted in 30 countries. The patients in EBBINGHAUS were an average of 63 years old. About 75 percent of them suffered from a heart attack, 20 percent suffered ischemic stroke and 19 percent had peripheral arterial disease. They were all receiving moderate to high-intensity stain therapy, and over the course of the study, the patients’ cognitive function was tested several times on a tablet computer.

“We found no important differences between patients taking evolocumab and those on placebo on any of the four measures of cognitive functioning, in the patient questionnaires or in the physician-report of adverse cognitive events,” Giugliano said. “We also looked at patients according to how low their levels of LDL cholesterol went. Patients who reached very low LDL values—less than 25 mg/dL—had cognitive function that was similar to those with higher LDL values.”