Statins in heart failure. Beyond the lipid lowering effect

Abstract Statins, the most widely prescribed medications in patients with hyperlipidemia and coronary heart disease, have a number of pleiotropic actions beyond cholesterol lowering. They improve endothelial function, they have antioxidant and anti-inflammatory effects, they regulate neovascularizat...

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Bibliographic Details
Published in:International journal of cardiology 2007-02, Vol.115 (2), p.144-150
Main Authors: Tousoulis, Dimitris, Charakida, Marietta, Stefanadi, Elli, Siasos, Gerasimimos, Latsios, George, Stefanadis, Christodoulos
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Endothelium, Vascular - drug effects
Endothelium, Vascular - physiopathology
Heart
Heart failure
Heart Failure - drug therapy
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Medical sciences
Statins
Trials
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Summary:Abstract Statins, the most widely prescribed medications in patients with hyperlipidemia and coronary heart disease, have a number of pleiotropic actions beyond cholesterol lowering. They improve endothelial function, they have antioxidant and anti-inflammatory effects, they regulate neovascularization and have immunomodulatory activities. Experimental evidence suggests that statins may be beneficial in heart failure as they can inhibit myocardial hypertrophy, reduce cardiomyocyte loss by apoptosis, reduce oxidative stress and restore neurohormonal imbalance. Furthermore small randomised clinical trials showed that short term statin administration may improve key pathophysiological aspects of this syndrome. Finally retrospective analyses of large statin trials imply a long term profit on clinical outcome in this group of patients. These results however need to be reviewed with caution as certain studies have demonstrated that low serum cholesterol is associated with worse prognosis in HF and that ubiquinone levels, a micronutrient with antioxidant actions, reduces significantly following statin administration. Large prospective randomised controlled trials are needed to confirm the beneficial effect of statins on cardiovascular outcome in HF patients and further elucidate the contributing mechanisms. Finally the statin dose and the interaction with co-administered drugs need to be studied.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2006.03.094