Controlling cholesterol may curtail another coronary.

If you've had a coronary attack and aren't taking a cholesterol-lowering drug because your cholesterol level is only average or moderately elevated. your doctor may be calling you in for reevaluation. An estimated 3 million Americans who have survived a heart attack are not taking drugs to lower their cholesterol for that reason. Now a major new study of more than 4,000 patients with a history of heart attack but with cholesterol levels averaging only 209 suggests that these 3 million are good candidates for drug therapy.

The study, presented at the annual meeting of the American College of Cardiology in Orlando, Florida. in late March, showed 37 percent fewer fatal heart attacks and 24 percent fewer nonfatal heart attacks in those who took the cholesterol-lowering drug Pravachol, compared with the other half of the group who were given a lookalike placebo. Researchers estimated that for every 1,000 patients who took the drug for an average of five years, 153 heart attacks or other serious cardiovascular problems were prevented. At a treatment cost of from $750 to $900 a year, the benefits are considerable, given that the incidence of bypass surgery was 26 percent lower, balloon angioplasty 22 percent lower, and stroke 28 percent lower in the treated group.

This was the third large-scale study in the past 18 months showing the value of this new class of drugs, known as statin medication. The best known of these are Zocor, manufactured by Merck and Company, and Pravachol, produced by Bristol Myers-Squibb, both of which have reported soaring sales in recent months.

Some researchers have raised concerns in the past that, based on animal studies, the long-term use of statin drugs might lead to an increase in cancer rates. Researchers in this latest study were surprised to find that, among the 580 women who participated, 12 in the group who took the drug developed breast cancer, compared to only one in the control group. However, the chairman of this study, Dr. Eugene Braunwald, professor of medicine at Harvard Medical School, feels that the drug was not a likely cause of this difference. As he noted, 149 of the patients in the drug group developed some type of cancer during the five years of the study, compared with 142 in the control group. Moreover, there was no evidence of an excess of breast cancer in the other two studies. (The women in this study, by the way, fared better than the men, with a 45 percent lower rate of heart attack and other adverse events than those among the women in the control group.)

RELATED ARTICLE: Health Recipe of the Month

Oriental Spinach Salad (Makes 8 servings)

1 package (10 oz.) fresh spinach, washed and shredded 10 water chestnuts, sliced 3 green onions, sliced 1 cup sliced mushrooms 1 small cucumber, peeled and sliced thin 2 tablespoons olive oil 2 tablespoons reduced-sodium soy sauce 3 tablespoons lemon juice 1 1/2 tablespoons honey 1 tablespoon sesame seeds, toasted

In salad bowl combine spinach, water chestnuts, green onions, mushrooms, and cucumber slices.

Mix olvie oil, soy sauce, lemon juice, and honey; pour over salad.

Sprinkle with sesame seeds.

Per Serving (1 1/4-1 1/2 cups): Calories: 77 Carbohydrate: 8.1 gm Cholesterol: 0 mg Protein: 2.1 gm Sodium: 180 mg Fat: 3.9 gm Diabetic exchange: 1 1/2 vegetable + 1 fat