Statins for heart failure: still caught in no man's land?
Statins are well-known for their ability to lower serum cholesterol levels, but have properties beyond mere cholesterol reduction, including an improvement in endothelial dysfunction, release of endothelial progenitor cells, anti-inflammatory properties and a number of antitumour activities. In the present issue of Clinical Science, Stumpf et al. show that a 4-week treatment course with the lipophilic statin atorvastatin ameliorates left ventricular remodelling and function, reduces serum levels of TNF-alpha (tumour necrosis factor-alpha), IL (interleukin)-6 and MCP-1 (monocyte chemoattractant protein-1), and increases both serum and myocardial levels of IL-10. The authors hypothesize that this shift from a pro- to an anti-inflammatory response might be beneficial in the clinical setting, because patients with low levels of IL-10 may fare worse than those with higher levels. In light of the recent setbacks with rosuvastatin in large-scale clinical trials, this notion requires further investigation, but highlights the need to identify those patients with heart failure who are likely to benefit from statin therapy.
von Haehling
Stephan
S
Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, D-13353 Berlin, Germany. stephan.von.haehling@web.de
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000069059:Atorvastatin; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000188:drug therapy*; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000097:blood; D011758:Pyrroles / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018836:Inflammation Mediators; D011758:Pyrroles; D000069059:Atorvastatin