Influence of co-existing atrial fibrillation on the efficacy of atorvastatin treatment in patients with dilated cardiomyopathy: a pilot study.
BACKGROUND
The aim of the study was to assess the influence of co-existing atrial fibrillation (AF) on inflammatory condition factors, left ventricular function, clinical course and the efficacy of statin treatment of congestive heart failure in the course of dilated cardiomyopathy (DCM).


METHODS
In a prospective, randomized, open-label study, 69 patients with DCM and left ventricular ejection fraction (LVEF) < or =40% were divided into two groups, with and without AF, who were treated according to the recommended standards. 68% of patients from the group with AF and 59% of patients from the group without AF were administered atorvastatin 40 mg daily for 8 weeks and 10 mg for next 4 months. Clinical examination with the assessment of body mass index (BMI) and waist size were followed by routine laboratory tests, measurement of concentration of tumor necrosis factor (TNF-alpha), interleukin-6 (IL-6), and IL-10 in blood plasma, N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration in blood serum, echocardiographic examination, and the assessment of exercise capacity in 6-minute walk test (6-MWT). After six months, morbidity rate and the number of heart failure hospitalizations were also observed.


RESULTS
In the whole population of patients, a significantly higher concentration of NT-proBNP was observed in the AF group (2669 +/- 2192 vs 1540 +/- 1067, p = 0.02). After statin treatment, in patients with DCM and co-existing AF, higher values of NT-proBNP and IL-6 were observed compared to non-AF patients (1530 +/- 1054 vs 1006 +/- 1195, p = 0.04 and (14.16 +/- 13.40 vs 6.74 +/- 5.45, p = 0.02, respectively).


CONCLUSIONS
In patients with DCM and co-existing AF, a weaker effect of atorvastatin concerning the reduction of IL-6 and NT-proBNP concentration was observed than in patients without atrial fibrillation.
Bielecka-Dabrowa
Agata
A
Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland. agatbiel7@poczta.onet.pl
Goch
Jan Henryk
JH
Rysz
Jacek
J
Maciejewski
Marek
M
Desai
Ravi
R
Aronow
Wilbert S
WS
Banach
Maciej
M
D000328:Adult; D000368:Aged; D000069059:Atorvastatin; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D015992:Body Mass Index; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000188:drug therapy*; D004452:Echocardiography / Q000379:methods; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010865:Pilot Projects; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015850:Interleukin-6; D010446:Peptide Fragments; D011758:Pyrroles; D014409:Tumor Necrosis Factor-alpha; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D016753:Interleukin-10; D000069059:Atorvastatin