title: Statin-mediated low-density lipoprotein lowering in chronic congestive heart failure.
abstract: Many theories and clinical trials have attempted to address the effect of low-density lipoprotein (LDL) lowering in chronic congestive heart failure (CHF). The current evidence suggests that there is no convincing reason for administering statins to patients with nonischemic heart failure. Although they do not reduce the mortality rate, statins reduce LDL cholesterol and may provide some benefit to patients with ischemic heart failure. In contrast, some authors believe that statin therapy may actually worsen outcomes in patients with CHF, especially if there is excessive reduction in LDL cholesterol. This review discusses the theories attempting to link the adverse effects of statin-mediated LDL lowering in CHF to increased levels of endotoxin or reduced levels of coenzyme Q10. In addition, the 2 largest randomized, double-blind, placebo-controlled clinical trials (CORONA and GISSI-HF) were discussed. It is clear that more trials are needed to definitely ascertain the effect of statins on CHF.
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute (CEK), Mount Sinai School of Medicine, New York, New York; Faculty of Medicine (HA, ME-H), Cairo University, Cairo, Egypt; St. Francis Hospital-The Heart Center (GW, TJV), Division of Cardiology, Center of Advanced Cardiac Therapeutics, Roslyn, New York; Department of Internal Medicine (MRK), Mount Sinai School of Medicine, New York, New York; and Cardiovascular Consultants of Long Island (KMG), PC, New Hyde Park, New York.
authors.forename: Constantine E
authors.initials: CE
authors.lastname: Kosmas
authors.forename: Hassan
authors.initials: H
authors.lastname: Alkhawam
authors.forename: Mohammed
authors.initials: M
authors.lastname: El-Hunjul
authors.forename: Gabriel
authors.initials: G
authors.lastname: Wagman
authors.forename: Mark R
authors.initials: MR
authors.lastname: Kahn
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Grady
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Vittorio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004731:Endotoxins / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D016896:Treatment Outcome; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D004731:Endotoxins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL; D014451:Ubiquinone; C024989:coenzyme Q10