Document Detail


Double-blind, randomized, placebo-controlled study of high-dose HMG CoA reductase inhibitor therapy on ventricular remodeling, pro-inflammatory cytokines and neurohormonal parameters in patients with chronic systolic heart failure.
MedLine Citation:
PMID:  17338996     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Statins decrease mortality in patients with coronary artery disease. However, chronic heart failure (CHF) patients were often excluded in such trials. Statins possess pharmacologic properties (independent of cholesterol lowering) that may be beneficial on ventricular remodeling in such patients. METHODS AND RESULTS: We conducted a 6-month randomized placebo (PBO)-controlled study of rosuvastatin (ROS) in patients with systolic (left ventricular ejection fraction [LVEF] <40%) CHF of ischemic or nonischemic etiology. The primary end point was change in LVEF by radionuclide ventriculogram. Secondary end points included change in echocardiographic parameters, neurohormonal and inflammatory markers, Packer composite score, death, and heart failure hospitalization. Patients were well matched for baseline values. Compared with PBO (n = 46), ROS patients (n = 40) had a decrease in low-density lipoprotein cholesterol (PBO +3, ROS -54%, P < .001). There was no significant change in LVEF by radionuclide ventriculogram (PBO +5.3, ROS +3.2%), fractional shortening by echocardiographic (PBO +2.7, ROS +1.8%), left ventricular end-diastolic diameter (PBO -1.7, ROS +0.8 mm), left ventricular end-systolic diameter (PBO -1.9, ROS +0.1 mm). Plasma norepinephrine, endothelin-1, brain natriuretic peptide, hsCRP, tumor necrosis factor-alpha and interleukin-6, patient global assessment, Packer composite, death/heart failure hospitalization, and adverse events were similar between PBO and ROS. CONCLUSIONS: Despite being safe and effective at decreasing plasma cholesterol, high-dose ROS did not beneficially alter parameters of LV remodeling. Reasons for absence of benefit are uncertain, but may include patient population studied, high dose of ROS used or high use of effective background CHF medications.
Authors:
Henry Krum; Emma Ashton; Christopher Reid; Victor Kalff; Jim Rogers; John Amarena; Bhuwan Singh; Andrew Tonkin
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  13     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-03-06     Completed Date:  2007-03-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM    
Affiliation:
Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chronic Disease
Cytokines / blood
Double-Blind Method
Female
Fluorobenzenes / pharmacology,  therapeutic use*
Heart Failure / blood,  drug therapy*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology,  therapeutic use*
Male
Middle Aged
Neurotransmitter Agents / blood
Pyrimidines / pharmacology,  therapeutic use*
Sulfonamides / pharmacology,  therapeutic use*
Systole
Ventricular Remodeling / drug effects
Chemical
Reg. No./Substance:
0/Cytokines; 0/Fluorobenzenes; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Neurotransmitter Agents; 0/Pyrimidines; 0/Sulfonamides; 287714-41-4/rosuvastatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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