January 19, 2006

Lipitor may be helpful in heart failure

NEW YORK -- Treatment with Lipitor (atorvastatin), one of the popular cholesterol-lowering "statin" drugs, can help the heart pump better in patients with heart failure, according to a new report.

By contrast, findings from a much smaller study showed that aside from lowering cholesterol levels, Lipitor did not benefit patients with heart failure. Both reports are published in the Journal of the American College of Cardiology.

"Although the reasons for these discrepant findings are not known, the most logical explanation is that the (group in the second study) had relatively mild heart failure" and thus there was less chance for Lipitor to show a benefit, Dr. Douglas L. Mann and Dr. Kumudha Ramasubbu, from Baylor College of Medicine in Houston, note in a related editorial.

Still, the second study is important because it shows that cholesterol lowering can be achieved in these patients without any obvious side effects using high-dose statin therapy, the editorialists point out.

In the first study, Dr. Srikanth Sola, from Emory University in Atlanta, and colleagues assessed the outcomes of 108 heart failure patients who were randomly assigned to receive Lipitor (20 milligrams per day) or inactive "placebo" for 12 months.

A significant improvement in the heart's pumping ability was noted in the Lipitor group during the study period, whereas a drop was observed in the placebo group. In addition, use of the drug appeared to reduce inflammation.

In the second study, Dr. Barry E. Bleske, from the University of Michigan at Ann Arbor, and colleagues assessed the outcomes of 15 patients with heart failure who were treated with Lipitor (80 milligrams per day) or placebo for 12-weeks and then crossed over to the other treatment for another 12 weeks.

With the exception of a significant drop in LDL ("bad") cholesterol levels, Lipitor therapy produced no beneficial, or harmful, effects in this patient group.

At present, statins can be recommended to heart failure patients with known heart disease and elevated levels of LDL cholesterol, Mann and Ramasubbu note. The broader question of whether these drugs should be given to all patients with heart failure remains unanswered, but several ongoing trials are addressing this topic, they add.

SOURCE: Journal of the American College of Cardiology, January 17, 2006.