Statins Could Aid Heart Failure Patients

Findings suggest the cholesterol-lowering drugs improve survival

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By Ed Edelson
HealthDay Reporter

TUESDAY, Oct. 31, 2006 (HealthDay News) -- Cholesterol-busting statin drugs can cut the risk of death and hospitalization for heart failure patients with high cholesterol, a major study finds.

The findings are the latest -- but certainly not the last -- contribution to the ongoing debate on whether statin drugs such as Lipitor, Pravachol and Zocor can help fight heart failure.

In fact, "[other] studies have suggested that statin therapy might make heart failure more severe and worsen heart function," said Dr. Alan S. Go., a research scientist at the Kaiser Permanente Division of Research and lead author of a report in the Journal of the American Medical Association.

However, this latest study "found quite the opposite," Go said. "There was a lower risk of death from any causes, and the risk of being hospitalized was not increased at all."

In fact, the incidence of hospitalization during the 2.4-year-long study was 21 percent lower for people taking statins than for those not taking the drugs, and the death rate was 24 percent lower.

The study was done because "studies have raised the question of whether giving statins in heart failure is safe," Go said. "On the basis of our findings, we would say that if people meet current treatment criteria for statin treatment, even if they have heart failure, you can safely give it and should give it,"

The study was limited in that it was only observational in nature, however. It was not the "gold standard" type of clinical trial where patients are randomized to receive either treatment or no treatment, with neither patients nor physicians knowing who is getting what.

But, "two such large clinical trials are trying to address this question," Go said. "Hopefully, we should have the results in a few years."

The current study included nearly 25,000 people diagnosed with heart failure, in which the heart progressively loses its ability to pump blood. About half had cholesterol levels high enough to warrant statin therapy.

Over the course of the study, the incidence of death for those taking statins was 12.5 per 100,000 person-years, compared to 19.1 for those not taking the drugs. The incidence of hospitalization for those taking statins was 21.4 per 100,000 person-years, compared to 28.2 for those not getting the drugs.

Belief that statins might do harm in heart failure is "purely theoretical," said Dr. William C. Little, chief of cardiology at Wake Forest University Baptist Medical Center, in Winston-Salem, N.C. His team reported a similar finding in a smaller study released last year.

It has been hypothesized that statins might damage heart function by lowering levels of helpful proteins such as coenzyme Q, Little said. And, it has been noted that people with heart failure who have low cholesterol do very poorly, he said.

"But people who are really sick with heart failure, that is a starvation situation," Little said. "That's why their cholesterol is low."

On the helpful side, "we know that statins can lower inflammation, and they also appear to improve the way blood vessels respond to stress," Go said.

Both Go and Little said they had no hesitation in prescribing a statin for someone with heart failure and high blood cholesterol.

"The majority do have the conventional indication for a statin," Little said.

More information

There's more on the pros and cons of statins at the U.S. National Heart, Lung and Blood Institute.

SOURCES: Alan S. Go, M.D., research scientist, Kaiser Permanente Division of Research, Oakland, Calif; William C. Little, M.D., chief of cardiology, Wake Forest University Baptist Medical Center, Winston-Salem, N.C; Nov. 1, 2006, Journal of the American Medical Association

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