Impact of Statin Therapy in Heart Failure Patients

Anderson, Jeffrey L.; May, Heidi T.; Le, Viet T; Muhlestein, Joseph B.; Horne, Benjamin D.; Bair, Tami L; Knight, Stacey; Knowlton, Kirk U.

doi:10.1016/j.jacadv.2023.100385

Cited by 4 publications

(3 citation statements)

References 31 publications

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“…As lipid-lowering medications, statins are well recognised for their ability to stabilise atherosclerotic plaques, enhance endothelial function, and reduce infl ammation, all of which may help to avert serious adverse cardiac events. The varying pharmacological features of the various statin types may have contributed to the variable death rates seen among them in our research [24]. For instance, the high-intensity statins Atorvastatin and Rosuvastatin, which are recognised for their powerful lipid-lowering eff ects, are the statins linked to the biggest decreases in mortality.…”

Section:  Discussionmentioning

confidence: 97%

Analyzing the Effects of Statin on Long Term Mortality in Coronary Artery Disease

Аджам,

Джасим

2023

Кардиология В Беларуси

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Цель. Изучение влияния различных видов и доз статинов на долгосрочную смертность у пациентов с ишемической болезнью сердца (ИБС), принимавших статины. Материалы и методы. 10 000 пациентов с ИБС были включены в ретроспективное когортное исследование в течение десятилетнего периода. Было выявлено 7000 пациентов, принимавших статины, и 3000, не принимавших их. Основным результатом стала смертность от всех причин. Принимая во внимание возможные мешающие факторы, отношение рисков (ОР) смерти оценивалось с использованием многомерных моделей пропорциональных рисков Кокса. Результаты. По сравнению с теми, кто не принимал статины, у тех, кто их принимал, наблюдался значительно более низкий уровень смертности в течение 10 лет (22% против 35%; p<0,001). Аторвастатин и розувастатин были связаны с самыми низкими показателями смертности (ОР: 0,63, 95% ДИ: 0,55–0,72; p<0,001 и ОР: 0,65, 95% ДИ: 0,58–0,74; p<0,001 соответственно). Различные виды статинов имели разные эффекты. По сравнению с лечением низкими дозами высокие и умеренные дозы продемонстрировали снижение смертности (ОР: 0,60, 95% ДИ: 0,52–0,69; p<0,001 и ОР: 0,70, 95% ДИ: 0,62–0,79; p<0,001 соответственно). Заключение. В зависимости от вида и дозы статинов их прием значительно снижает отдаленную смертность у пациентов с ИБС. Эти результаты подчеркивают ценность индивидуализированного подхода к лечению статинами для достижения наилучшего контроля ИБС. Purpose. To investigate the effects of various statin kinds and doses on long-term mortality in patients with coronary artery disease (CAD) who were taking statins. Materials and methods. 10,000 CAD patients were the subject of a retrospective cohort study during a ten- year period. There were identified 7,000 statin users and 3,000 non- users. All-cause mortality was the major result. Taking into account possible confounders, hazard ratios (HRs) for death were estimated using multivariable Cox proportional hazards models. Results. When compared to non-users, statin users had a considerably reduced 10-year mortality rate (22 percent vs 35 percent; p<0.001). Atorvastatin and Rosuvastatin were related with the lowest mortality rates (HR: 0.63, 95 percent CI: 0.55–0.72; p<0.001 and HR: 0.65, 95 percent CI: 0.58–0.74; p<0.001, respectively). Different kinds of statins had varied effects. When compared to low-dose treatment, high and moderate doses of statin medication demonstrated reduced mortality (HR: 0.60, 95 percent CI: 0.52–0.69; p<0.001 and HR: 0.70, 95 percent CI: 0.62–0.79; p<0.001, respectively). Conclusion. According to statin type and dose, statin medication considerably lowers long-term mortality in CAD patients. These results highlight the value of individualised statin medication in achieving the best CAD control.

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Section:  Discussionmentioning

confidence: 97%

Analyzing the Effects of Statin on Long Term Mortality in Coronary Artery Disease

Аджам,

Джасим

2023

Кардиология В Беларуси

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“…57 Recent large real-world observational findings also supports a potential benefit of using statins for HFrEF. 58 ESC guidelines indicate that the routine use of statins in patients with HF without other indications for their use, such as CAD, is not recommended but it is recommended for individuals who have a high risk for atherosclerotic cardiovascular disease to reduce HF hospitalisations. 39 The American College of Cardiology/ American Heart Association cholesterol management guideline gives use of statins a IIb class of recommendation (with usefulness/efficacy less well established by evidence/opinion) for ICM with HFrEF and a reasonable life expectancy.…”

Section: Critical Appraisalmentioning

confidence: 99%

Coronary Revascularisation in Heart Failure with Reduced Ejection Fraction

Haring,

Böhm

2024

J Asian Pac Soc Cardiol

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The role of myocardial revascularisation in patients suffering from ischaemic cardiomyopathy with extensive coronary artery disease and heart failure with reduced ejection fraction (HFrEF) remains controversial. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are considered revascularisation procedures. Evidence prior to the latest medical treatment advances only suggests a long-term benefit of CABG over pharmacological therapy in this population. When angina-related symptoms dominate patients’ lives despite optimal medical treatment, PCI can be considered if the patient is ineligible for CABG after carefully weighing up the perioperative risk. Viability and/or ischaemia detection to guide revascularisation have been unable to accurately predict treatment effects of CABG or PCI. Optimal heart failure treatment should be initiated in all patients presenting with ischaemic cardiomyopathy and HFrEF as the first and most important measure to improve long-term prognosis.

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“…The antiinflammatory and lipid lowering effects of statins may also provide benefits for diabetic cardiomyopathy; however, randomized controlled clinical trials have yet to substantiate the cardiovascular benefits of statin usage in patients with heart failure [227,228]. Conversely, it is noteworthy that a meta-analysis [229], a retrospective cohort study based on data from the Kaiser Permanente Southern California [230], and a recent retrospective database analysis of large single health care practice [231] have suggested a potential benefit of selectively using statins for clinical outcomes in patients with HFrEF and ASCVD or in patients with HFpEF [230] in real-world clinical settings. Future research is required to determine the benefits of statin usage in patients with heart failure, particularly those with non-atherosclerotic CVD origins, such as diabetic cardiomyopathy.…”

Section: Drugs For Diabetes and Dyslipidemiamentioning

confidence: 99%

Lipotoxicity as a therapeutic target in obesity and diabetic cardiomyopathy

Nakamura

2024

J. pharm. pharm. sci.

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Unhealthy sources of fats, ultra-processed foods with added sugars, and a sedentary lifestyle make humans more susceptible to developing overweight and obesity. While lipids constitute an integral component of the organism, excessive and abnormal lipid accumulation that exceeds the storage capacity of lipid droplets disrupts the intracellular composition of fatty acids and results in the release of deleterious lipid species, thereby giving rise to a pathological state termed lipotoxicity. This condition induces endoplasmic reticulum stress, mitochondrial dysfunction, inflammatory responses, and cell death. Recent advances in omics technologies and analytical methodologies and clinical research have provided novel insights into the mechanisms of lipotoxicity, including gut dysbiosis, epigenetic and epitranscriptomic modifications, dysfunction of lipid droplets, post-translational modifications, and altered membrane lipid composition. In this review, we discuss the recent knowledge on the mechanisms underlying the development of lipotoxicity and lipotoxic cardiometabolic disease in obesity, with a particular focus on lipotoxic and diabetic cardiomyopathy.

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Impact of Statin Therapy in Heart Failure Patients

Cited by 4 publications

References 31 publications

Analyzing the Effects of Statin on Long Term Mortality in Coronary Artery Disease

Analyzing the Effects of Statin on Long Term Mortality in Coronary Artery Disease

Coronary Revascularisation in Heart Failure with Reduced Ejection Fraction

Lipotoxicity as a therapeutic target in obesity and diabetic cardiomyopathy

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