Rosuvastatin in Older Patients with Systolic Heart Failure

• Published in: The New England journal of medicine Vol. 357; no. 22; pp. 2248 - 2261
• Main Authors: Kjekshus, John, Apetrei, Eduard, Barrios, Vivencio, Böhm, Michael, Cleland, John G.F, Cornel, Jan H, Dunselman, Peter, Fonseca, Cândida, Goudev, Assen, Grande, Peer, Gullestad, Lars, Hjalmarson, Åke, Hradec, Jaromir, Jánosi, András, Kamenský, Gabriel, Komajda, Michel, Korewicki, Jerzy, Kuusi, Timo, Mach, François, Mareev, Vyacheslav, McMurray, John J.V, Ranjith, Naresh, Schaufelberger, Maria, Vanhaecke, Johan, van Veldhuisen, Dirk J, Waagstein, Finn, Wedel, Hans, Wikstrand, John
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 29.11.2007
• Subjects: adverse effects; Aged; Cardiovascular disease; Cardiovascular Diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; complications; Drug therapy; epidemiology; etiology; Female; Fluorobenzenes; Fluorobenzenes - adverse effects; Fluorobenzenes - therapeutic use; Follow-Up Studies; Heart attacks; Heart Failure; Heart Failure - drug therapy; Heart Failure - etiology; Hospitalization; Hospitalization - statistics & numerical data; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Male; MEDICAL AND HEALTH SCIENCES; MEDICIN OCH HÄLSOVETENSKAP; Middle Aged; mortality; Myocardial Ischemia; Myocardial Ischemia - complications; Proportional Hazards Models; Pyrimidines; Pyrimidines - adverse effects; Pyrimidines - therapeutic use; Rosuvastatin Calcium; Single-Blind Method; statistics & numerical data; Sulfonamides; Sulfonamides - adverse effects; Sulfonamides - therapeutic use; Systole; therapeutic use; Treatment Outcome
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa0706201

In this clinical trial, rosuvastatin was compared with placebo in elderly patients with systolic, ischemic heart failure. Although rosuvastatin significantly lowered levels of both low-density lipoprotein cholesterol and high-sensitivity C-reactive protein, it did not significantly reduce cardiovascular outcomes. However, it did reduce the number of hospitalizations. On the basis of these data, the role of statin therapy in heart failure appears to be limited. Although rosuvastatin significantly lowered levels of both low-density lipoprotein cholesterol and high-sensitivity C-reactive protein, it did not significantly reduce cardiovascular outcomes. Although a high proportion of patients with heart failure caused by left ventricular systolic dysfunction have coronary artery disease, reported rates of myocardial infarction have been low in previous clinical trials. 1 – 4 Therefore, the potential value of statins has been questioned because their benefit is largely due to the prevention of myocardial infarction. In addition, in this population of patients, low levels of total cholesterol are common and are associated with worse outcomes. 1 – 6 Lipoproteins may remove endotoxins that enter the circulation through the intestinal wall, which may be edematous and leaky in patients with heart failure. 7 Statins could also . . .