title: Immediate administration of atorvastatin decreased the serum MMP-2 level and improved the prognosis for acute heart failure.
abstract: OBJECTIVE
  We have reported that matrix metalloproteinase-2 (MMP-2) increased in acute heart failure (AHF) and better prognosis was found in patients with greater reduction in MMP-2. We assessed whether a statin decreased MMP-2 in AHF.
  
  
  RESULTS
  The serum MMP-2 levels were measured on admission (Day 1), Day 3, Day 7, and Day 14 in 50 AHF patients. The patients were randomized to either atorvastatin (n=25) or control group (n=25). Atorvastatin (10-20mg/day) was started within 12h after their admission and then was continued for two weeks. There were no differences in the serum levels of MMP-2 on Day 1 between atorvastatin group (1400.4±318.6ng/ml) and control group (1292.7±384.7ng/ml). MMP-2 significantly decreased in both groups on Day 3, 7, and 14. However, the MMP-2 value on Day 3 compared to Day 1 was observed to have decreased significantly in atorvastatin group (561.8±235.1ng/ml) compared to control group (272.6±270.6ng/ml; p=0.001). HF events which were defined as death from HF, readmission to hospital for HF, or prolonged hospital stay because of uncontrollable HF, occurred more in control group than in atorvastatin group. Kaplan-Meier curves showed that the prognosis of HF was significantly better in atorvastatin group as compared with control group (log-rank test, p=0.037).
  
  
  CONCLUSIONS
  In addition to conventional HF therapy, an early start of atorvastatin caused a great decrease in MMP-2 and also improved HF events in AHF.
authors.affiliation: Nippon Medical School, Chiba, Japan. s6042@nms.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shirakabe
authors.forename: Kuniya
authors.initials: K
authors.lastname: Asai
authors.forename: Noritake
authors.initials: N
authors.lastname: Hata
authors.forename: Shinya
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinada
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tomita
authors.forename: Masafumi
authors.initials: M
authors.lastname: Tsurumi
authors.forename: Masato
authors.initials: M
authors.lastname: Matsushita
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000069059:Atorvastatin; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality; D006538:Heptanoic Acids / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology; D053208:Kaplan-Meier Estimate; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D011379:Prognosis; D011758:Pyrroles / Q000008:administration & dosage* / Q000494:pharmacology; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; C522361:MMP2 protein, human; D020778:Matrix Metalloproteinase 2