Treatment with atorvastatin is associated with a better prognosis in chronic heart failure with systolic dysfunction: results from The Daunia Heart Failure Registry

Abstract

BackgroundFew works have evaluated the effect of statins on left ventricular dysfunction in patients with chronic heart failure (CHF), by using tissue Doppler imaging (TDI). We therefore aimed to investigate whether atorvastatin treatment may influence prognosis and myocardial performance evaluated by TDI in subjects with CHF.MethodsFive hundred thirty-two consecutive CHF outpatients enrolled in a local registry, the Daunia Heart Failure Registry, were prospectively analysed. 195 patients with CHF and left ventricular ejection fraction (LVEF) ≤40 %, either in treatment with atorvastatin (N: 114) or without statins (N: 81), underwent TDI examination. Adverse events were evaluated during follow-up.ResultsThe atorvastatin group showed a lower incidence of adverse events (cardiac death: 0 % vs 7 %, p < 0.01), and better TDI performance (E/E’ 15 ± 5.7 vs 18 ± 8.3, p < 001) than controls. Ischaemic CHF patients in treatment with atorvastatin also showed a lower incidence of adverse events (death: 10 % vs 26 %, p < 0.05; sustained ventricular arrhythmias: 5 % vs 19 %, p < 0.05, cardiac death: 0 vs 8 %, p < 0.05) and better TDI performance (E/E’ ratio: 15.00 ± 5.68 vs 19.72 ± 9.14, p < 0.01; St: 353.70 ± 48.96 vs 303.33 ± 68.52 msec, p < 0.01) than controls. The association between atorvastatin and lower rates of cardiac death remained statistically significant even after correction in a multivariable analysis (RR 0.83, 95 % CI 0.71–0.96, p < 0.05 in CHF with LVEF ≤40 %; RR 0.77, 95 % CI 0.62–0.95, p < 0.05 in ischaemic CHF with LVEF ≤40 %).ConclusionsTreatment with atorvastatin in outpatients with systolic CHF is associated with fewer cardiac deaths, and a better left ventricular performance, as assessed by TDI.

Simvastatin reduces TGF-β1-induced SMAD2/3-dependent human ventricular fibroblasts differentiation: Role of protein phosphatase activation

“…Statins — 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase inhibitors — are a class of cholesterol-lowering drugs that also reduce the incidence of postoperative AF, left ventricular dysfunction, and maladaptive tissue remodeling with their pleiotropic effects independent of cholesterol-lowering [21–24]. Statins recently were demonstrated to dephosphorylate signaling proteins by activating PP2A or PPM1A in extra-cardiac liver cell lines and neurons [25–28].…”

Changes of Naturally Occurring CD4⁺CD25⁺ FOXP3⁺ Regulatory T Cells in Patients With Acute Coronary Syndrome and the Beneficial Effects of Atorvastatin Treatment

“…20) Treatment with atorvastatin, in particular, has been shown to be superior in preventing and treating cardiovascular disease. [21][22][23] Correlation analysis suggested that Tregs frequency and function positively are correlated with left ventricular ejection fraction, but negatively correlated with left ventricular end-diastolic dimension and Nterminal pro-brain natriuretic peptide (NT-proBNP) in patients with CHF. 24) Zhang, et al 25) demonstrated that atorvastatin treatment was associated with reduced all-cause mortality and readmission rate for heart failure (HF), and the superiority of statin therapy was significant in CHF patients younger than 65 years.…”

An Integrated System Biology Approach Yields Drug Repositioning Candidates for the Treatment of Heart Failure

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