title: Impact of statin therapy on systemic inflammation, left ventricular systolic and diastolic function and prognosis in low risk ischemic heart disease patients without history of congestive heart failure.
abstract: OBJECTIVE
  The aim of this study was to investigate the impact of statin on systemic inflammation, left ventricular systolic and diastolic function and prognosis in low risk ischemic heart disease (IHD) patients.
  
  
  METHODS
  A total of 430 consecutive IHD patients without congestive heart failure were enrolled. One hundred and thirty-two patients (31%) were treated with statin (statin group) and 298 patients (69%) were not (no statin group). Echocardiographic indices, high sensitivity CRP, and prognosis were compared.
  
  
  RESULTS
  Ejection fraction (EF) was significantly higher in the statin group (p<0.01). The ratio of the early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/E') was significantly lower in the statin group than in the no statin group (p<0.01). Although LDL-cholesterol level did not differ, high sensitivity CRP level was significantly lower in the statin group (0.3+/-0.5 vs. 1.1+/-2.3 mg/dl, p=0.005). Cardiac event-(cardiac death and congestive heart failure)free survival rate was significantly higher in the statin group than in no statin group (Log-rank p<0.0001). By multivariate logistic regression analysis, E/E' > 15 (p=0.002), EF < 50% (p=0.003), lack of statin use (p=0.009), left atrial dimension (p=0.02), use of diuretics (p=0.03) and lack of beta-blockers (p=0.04) were independent predictors of cardiac events. In 248 patients matched by propensity scores, statin remained associated with better event-free survival (Log-rank p=0.006).
  
  
  CONCLUSIONS
  Statin may improve left ventricular function and thus improve the prognosis in low risk patients with IHD.
authors.affiliation: Division of Cardiology, Bell Land General Hospital, Sakai. hokura@fides.dti.ne.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Asawa
authors.forename: Tomoichiro
authors.initials: T
authors.lastname: Kubo
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Taguchi
authors.forename: Iku
authors.initials: I
authors.lastname: Toda
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003971:Diastole; D005260:Female; D006333:Heart Failure; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D011379:Prognosis; D013599:Systole; D016277:Ventricular Function, Left / Q000187:drug effects*