January 19, 2006

‘Statin’ drug may be helpful in heart failure

NEW YORK (Reuters Health) - 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

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.