receptor
II) were significantly lower in the statin group than in the placebo
group.Patients with coronary artery disease and ischemic cardiomyopathy routinely receive statin therapy, but should patients with nonischemic heart failure also receive statins? In this 1-year study, investigators randomized 108 patients with nonischemic heart failure and left ventricular ejection fractions (LVEF) of 35% or lower to daily atorvastatin (20 mg) or placebo.
Mean LVEF improved significantly (from 33% to 37%) and mean LV
dimensions were reduced in the atorvastatin group, whereas LVEF
declined significantly (from 33% to 31%) and LV dimensions increased
in the placebo group. Mean concentrations of inflammation markers
(C-reactive protein, interleukin-6, tumor necrosis factor-
receptor
II) were significantly lower in the statin group than in the placebo
group.
These data suggest that statins improve LVEF and halt LV enlargement and remodeling. The results add to evidence gathered from several small or nonrandomized studies in which statins benefited heart failure patients. The demonstrated effect on inflammatory markers is a potential pathway for this benefit. An editorialist notes that several large-scale outcome trials on this question are underway, which should give us more definitive data on the role of statins in nonischemic heart failure.
Reference:
1. Sola S et al. Atorvastatin improves left ventricular systolic function and serum markers of inflammation in nonischemic heart failure. J Am Coll Cardiol 2006 Jan 17; 47:332-7.
2. Ramasubbu K and Mann DL. The emerging role of statins in the treatment of heart failure. J Am Coll Cardiol 2006 Jan 17; 47:342-4.