Statins in Heart Failure—Where Do We Stand?

Lyons, Kristopher; McVeigh, Gary E.; Harbinson, Mark

doi:10.1007/s10557-010-6269-1

Cited by 5 publications

(3 citation statements)

References 47 publications

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“…[21] Moreover, several studies have indicated that statin induced mitochondrial dysfunction with decreased CoQ10 levels, [22][23][24] which may correlate with a poor prognosis in patients with heart failure. [25][26][27][28] On the other hands, combination therapy of statins and exercise increased the ratio of CoQ10 to LDL cholesterol. [29] In the present study population, CoQ10 levels decreased in patients treated with statins.…”

Section: Lu Et Al Reported That the Mean Coq10 Level Among 146 Health...mentioning

confidence: 99%

Low circulating coenzyme Q10 during acute phase is associated with inflammation, malnutrition, and in-hospital mortality in patients admitted to the coronary care unit

et al. 2016

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Coenzyme Q10 (CoQ10) has a potential role in the prevention and treatment of heart failure through improved cellular bioenergetics. In addition, it has antioxidant, free radical scavenging, and vasodilatory effects that may be beneficial. Although critical illness in intensive care unit is associated with decreased circulating CoQ10 levels, the clinical significance of CoQ10 levels during acute phase in the patients of cardiovascular disease remains unclear. We enrolled 257 consecutive cardiovascular patients admitted to the coronary care unit (CCU). Serum CoQ10 levels were measured after an overnight fast within 24 h of admission. We examined the comparison of serum CoQ10 levels between survivors and in-hospital mortalities in patients with cardiovascular disease. Serum CoQ10 levels during the acute phase in patients admitted to the CCU had similar independent of the diagnosis. CoQ10 levels were significantly lower in patients with in-hospital mortalities than in survivors (0.43 ± 0.19 vs. 0.55 ± 0.35 mg/L, P = 0.04). In patients admitted to the CCU, CoQ10 levels were negatively associated with age and C-reactive protein levels, and positively associated with body mass index, total cholesterol, and high-density lipoprotein cholesterol levels. Low CoQ10 levels correlated with low diastolic blood pressure. Multivariate logistic regression analysis demonstrated that low CoQ10 levels were an independent predictor of in-hospital mortality. Low serum CoQ10 levels during acute phase are significantly associated with cardiovascular risk and in-hospital mortality in patients admitted to the CCU.

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Section: Lu Et Al Reported That the Mean Coq10 Level Among 146 Health...mentioning

confidence: 99%

Low circulating coenzyme Q10 during acute phase is associated with inflammation, malnutrition, and in-hospital mortality in patients admitted to the coronary care unit

et al. 2016

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“…The literature has shown that dyslipidemia and obesity may be related to a better prognosis in heart failure patients, but the concept is still questioned (30)(31)(32)(33). Although observational and mechanistic studies suggest that statins benefit the prognosis of heart failure patients, larger randomized controlled trials have failed to demonstrate the expected benefits, and statin treatment in heart failure is also not determined in the clinical situation (33)(34)(35). Thus, further well-designed prospective studies are strongly needed to resolve the issue of dyslipidemia and statins in heart failure.…”

Section: Limitationsmentioning

confidence: 99%

Cardiac Mortality Assessment Improved by Evaluation of Cardiac Sympathetic Nerve Activity in Combination with Hemoglobin and Kidney Function in Chronic Heart Failure Patients

Doi

Nakata²,

Hashimoto³

et al. 2012

J Nucl Med

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We examined prognostic interactions among cardiac autonomic function assessed by 123 I-labeled metaiodobenzylguanidine ( 123 I-MIBG) activity, hemoglobin, and kidney function in chronic heart failure patients. Anemia, chronic kidney disease, and impairment of cardiac sympathetic function have been shown as determinants of prognosis in heart failure patients, but there has been little information on their synergistic correlations with cardiac mortality. Methods: After evaluations of hemoglobin and estimated glomerular filtration rate (GFR), 468 heart failure patients with left ventricular ejection fraction less than 50% underwent cardiac 123 I-MIBG imaging before discharge and were then followed up for a mean interval of 60.5 mo with a primary endpoint of cardiac death. Cardiac 123 I-MIBG activity was quantified using heart-to-mediastinum ratio (HMR) and washout rate. Results: For 89 fatal cardiac events documented (19.0%), besides New York Heart Association class, multivariate Cox analysis revealed HMR, hemoglobin, and estimated GFR as significant independent determinants, with hazard ratios of 0.215 (P 5 0.0129; 95% confidence interval [CI], 0.064-0.718), 0.821 (P 5 0.0062; 95% CI, 0.708-0.946), and 0.984 (P 5 0.0243; 95% CI, 0.970-0.998), respectively. Receiver-operating-characteristic analysis determined the thresholds for identifying patients at increased risk for cardiac death to be 1.57 for HMR, 11.9 g/dL for hemoglobin, and 46.4 mL/min/1.73 m 2 for estimated GFR. Combining the 4 independent predictors incrementally (P , 0.05) improved prognostic powers maximally up to a global x 2 value of 97.3 compared with sole or other combinations. Conclusion: Hemoglobin, kidney function, and alterations of cardiac sympathetic nerve activity are independently and synergistically associated with increased cardiac mortality in chronic heart failure patients, together with New York Heart Association functional class.

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“…91,92 An extensive review on the effects of statins in arteriosclerosis and heart failure may be found elsewhere. [93][94][95]…”

Section: Interactions Between Statins and The Raas In Cardiovascular Diseasesmentioning

confidence: 99%

Statins, the renin–angiotensin–aldosterone system and hypertension – a tale of another beneficial effect of statins

Drapała

Sikora

Ufnal

2014

J Renin Angiotensin Aldosterone Syst

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Background: Statins, a class of lipid lowering drugs, decrease mortality associated with cardiovascular events. As hypercholesterolemia is often accompanied by hypertension, a large number of patients receive therapy with statins and antihypertensive drugs which act via the renin-angiotensin-aldosterone system (RAAS). New guidelines published by the American Heart Association and American College of Cardiology on the treatment of dyslipidaemia and the reduction of atherosclerotic cardiovascular risk, which use a risk prediction algorithm based on risk factors such as hypertension but not low-density lipoprotein (LDL) level, may even further increase the number of patients receiving such concomitant therapy. Method: In this paper we review studies on an interaction between statins, the RAAS and antihypertensive drugs acting via the RAAS. Result: Accumulating evidence suggests that the combination of statins and drugs affecting the RAAS exerts a synergistic effect on the circulatory system. For example, statins may lower arterial blood pressure and augment the effect of antihypertensive drugs acting via the RAAS. Statins may interact with the RAAS in a number of ways i.e. to decrease the expression of receptors for angiotensin II (Ang II), inhibit the Ang II-dependent intracellular signalling, reduce the RAASdependent oxidative stress and inflammation as well as inhibit the synthesis of Ang II and aldosterone. Conclusion:Although statins given either alone or together with antihypertensive drugs acting via the RAAS may lower arterial blood pressure, further research is needed to evaluate the mechanisms and their therapeutic significance.

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Statins in Heart Failure—Where Do We Stand?

Cited by 5 publications

References 47 publications

Low circulating coenzyme Q10 during acute phase is associated with inflammation, malnutrition, and in-hospital mortality in patients admitted to the coronary care unit

Low circulating coenzyme Q10 during acute phase is associated with inflammation, malnutrition, and in-hospital mortality in patients admitted to the coronary care unit

Cardiac Mortality Assessment Improved by Evaluation of Cardiac Sympathetic Nerve Activity in Combination with Hemoglobin and Kidney Function in Chronic Heart Failure Patients

Statins, the renin–angiotensin–aldosterone system and hypertension – a tale of another beneficial effect of statins

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