Statin Therapy Is Associated With Improved Cardiovascular Outcomes and Levels of Inflammatory Markers in Patients With Heart Failure
Received 29 September 2004; received in revised form 23 May 2005; accepted 25 May 2005.
Abstract
Background
We wished to determine whether the addition of statins affect cardiovascular events and markers of inflammation in patients with heart failure.
Methods and Results
A total of 446 patients with heart failure and ejection fraction ≤35% were followed in a prospective, nonrandomized fashion and were classified according to treatment with a statin. We determined all-cause mortality, cardiovascular morbidity, and serum markers of inflammation over a 24-month period. Statin therapy in patients with heart failure was associated with decreased all-cause mortality at 2 years compared with those not on statin therapy (15% versus 33%, P < .005) as well as hospitalizations for heart failure (22% versus 38%, P = .001) and nonfatal myocardial infarction (11% versus 15%, P < .001). In addition, statin therapy was associated with a decrease in serum levels of C-reactive protein (1.12 ± 0.13 versus 1.47 ± 0.11 mg/dL, P = .001), interleukin-6 (13.3 ± 0.8 versus 17.3 ± 1.4 ng/dL, P = .001), and tumor necrosis factor-alpha receptor II (24.3 ± 1.0 versus 34.5 ± 3.0 ng/dL, P = .001).
Conclusion
The use of statin therapy in this nonrandomized trial was associated with a significant reduction in all-cause mortality and cardiac morbidity. In addition, the improvement in levels of several serum inflammatory markers with statin therapy suggests in part possible mechanisms by which these agents may exert their benefits.
Atlanta, Georgia; New York, New York; Shreveport, Louisiana
1From the Emory University School of Medicine, Division of Cardiology, Atlanta, Georgia
2Mount Sinai School of Medicine, Division of Cardiology, New York, New York
3Louisiana State University Health Sciences Center, Division of Cardiology, Shreveport, Louisiana
Reprint requests: Bobby V. Khan, MD, PhD, Division of Cardiology, Department of Medicine, Emory University School of Medicine, 69 Jesse Hill Drive SE, #C247, Atlanta, GA 30303
Supported by an unrestricted educational grant from Pfizer Pharmaceuticals and funds from the Emory Medical Care Foundation.
ABSTRACT