A new study has good news for people who can’t — or won’t — take statin drugs to lower their cholesterol levels. A daily pill, bempodoic acid, has the potential to lower the risk of major cardiovascular events such as a heart attack or stroke for these individuals.

According to NBC News, this statin alternative may help reduce deaths from heart disease among people with high levels of LDL, the so-called “bad” cholesterol. New research found that bempodoic acid taken daily lowered LDL and resulted in a 39% reduction in heart attacks and heart disease deaths, scientists reported Saturday at the American Diabetes Association’s annual meeting.

Dr. Steven Nissen, chief academic officer of the Heart, Vascular & Thoracic Institute at the Cleveland Clinic, and lead author of the breakthrough study, said the results surprised him. “I hope this will be a wakeup call for patients and physicians,” he said.

Nissen said that currently fewer than half the people who should be taking a cholesterol-lowering medication because of heart disease risk are taking it.

“Treating people who have risk factors before their first cardiovascular event would have large benefits,” not just in preventing complications but in preventing mortality, he said.

Bempodoic acid was approved in 2020 by the Food and Drug Administration but is not as effective as statins in treating high cholesterol. While statins are the gold standard of cholesterol medications, they come with potential side effects, such as muscle pain, headaches, sleep problems and digestive problems. As many as 20% of people at high risk of heart disease — mainly women — refuse to take the medication.

The study examined the impact of bempodoic acid on individuals who had adverse reactions to statin drugs and found lowering cholesterol resulted in a significant decrease in heart attacks and heart disease-related deaths in this group.

The new study involved 4,206 participants who had never been diagnosed with heart disease but had risk factors, such as diabetes, high LDL, and hypertension. The average age of the study subjects was 68 and 59% were women. Two-thirds had diabetes, says NBC News, and the average LDL level of participants was 142.5 mg/dL. (Most adults should keep their LDL level below 100).

After six months, the group who took a daily dose of bempodoic acid had a 23.2% reduction in LDL levels and a 22.7% decrease in inflammation caused by protein in the blood, which is linked to heart and stroke risk, compared to the placebo group.

Other key findings of the study that tracked the participants for a three-year period included:

• Men and women who took bempodoic acid had an impressive 39% reduced risk of heart attacks.

• Heart disease-related death fell by 39% in the bempodoic group..

• The combined risk of a patient dying, having a heart attack or a stroke was cut by 36% in those taking the medication.

There was a small risk of developing gout and gallstones in the group who took medication versus the one who took a placebo.

But according to USA Today, cardiologists are quick to point out that bempodoic acid should typically not be used instead of statins. It’s far more expensive and doesn’t have the decades-long track record of safety. But for individuals who can’t tolerate statins, or a high enough dose to bring their cholesterol levels down adequately, the new study suggests it’s important to find alternatives, and that bempodoic acid can be at least part of the solution.

Bempodoic acid is sold by Esperion Therapeutics of Ann Arbor, Michigan, under the brand name Nexletol, and is often prescribed in combination with another cholesterol-lowering drug, ezetimibe, and sold as Nexlizet. Both drugs cost about $400 monthly, says USA Today.

However, Sheldon Koenig, CEO and president of Esperion, who funded the study, said the drug is now covered by many insurance companies.

“For Medicare, the company has preferred status and the copay is generally only $45 per month,” he said.