Experimental and clinical basis for the use of statins in patients with ischemic and nonischemic cardiomyopathy.
Over the past 2 decades our understanding of the pathologic mechanisms that lead to heart failure (HF) has evolved from simplistic hemodynamic models to more complex models that have implicated neurohormonal activation and adverse cardiac remodeling as important mechanisms of disease progression. 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have become a standard part of the armamentarium in the prevention and treatment of coronary artery disease. Apart from their lipid-lowering capabilities, statins seem to have non-lipid-lowering effects that impact neurohormonal activation and cardiac remodeling. This review will examine the potential benefits of statins in HF patients with ischemic and nonischemic cardiomyopathy as well as potential concerns regarding the use of statins in these patients.
Ramasubbu
Kumudha
K
Winters Center for Heart Failure Research, Department of Medicine, Baylor College of Medicine and The Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
Estep
Jerry
J
White
Donna L
DL
Deswal
Anita
A
Mann
Douglas L
DL
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D001337:Autonomic Agents / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D016207:Cytokines / Q000187:drug effects / Q000378:metabolism; D004341:Drug Evaluation; D004730:Endothelium, Vascular / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006984:Hypertrophy / Q000188:drug therapy / Q000473:pathology; D008074:Lipoproteins / Q000187:drug effects / Q000378:metabolism; D017202:Myocardial Ischemia / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D018377:Neurotransmitter Agents / Q000378:metabolism; D051140:Selenoproteins / Q000187:drug effects / Q000378:metabolism; D016896:Treatment Outcome; D014451:Ubiquinone / Q000187:drug effects / Q000378:metabolism; D020257:Ventricular Remodeling / Q000187:drug effects
D000889:Anti-Arrhythmia Agents; D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D001337:Autonomic Agents; D016207:Cytokines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008074:Lipoproteins; D018377:Neurotransmitter Agents; D051140:Selenoproteins; D014451:Ubiquinone