title: Effects of lipophilic statins for heart failure: a meta-analysis of 13 randomised controlled trials.
abstract: BACKGROUND
  The effects of lipophilic statins in heart failure (HF) were controversial. The goal of the present study was to systematically review all randomised controlled trials evaluating the effects of lipophilic statins in patients with HF.
  
  
  METHODS
  We performed a comprehensive literature search to identify eligible trials that prospectively randomised patients with HF to lipophilic statins or control. Primary end points were all-cause mortality, cardiovascular mortality, hospitalisation for worsening HF, left ventricular ejection fraction (LVEF), and low-density lipoprotein cholesterol. Risk ratios (RRs) and Weighted mean differences (WMDs) were calculated using fixed-effects models or random-effects models.
  
  
  RESULTS
  A total of 13 randomised trials with 1,532 subjects were included in this analysis. Ten trials randomised patients to atorvastatin, two to simvastatin, and one to pitavastatin. Overall, lipophilic statins significantly decreased all-cause mortality (RR 0.53, P<0.001), cardiovascular mortality (RR 0.66, P=0.04), and hospitalisation for worsening HF (RR 0.60, P<0.001). Subgroup analyses showed that the effects of lipophilic statins in HF were not modified by age, baseline LVEF, and cause of HF. In addition, patients randomised to lipophilic statins had a significant increase in LVEF (WMD 3.91%, P<0.001) and decrease in low-density lipoprotein cholesterol (WMD 0.90 mmol/L, P<0.001).
  
  
  CONCLUSIONS
  It appears that further studies are needed to determine if lipophilic statins are beneficial for HF patients.
authors: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
authors: Gang
authors: G
authors: Liu
authors: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
authors: Xin-Xin
authors: XX
authors: Zheng
authors: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
authors: Yan-Lu
authors: YL
authors: Xu
authors: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
authors: Jie
authors: J
authors: Lu
authors: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
authors: Ru-Tai
authors: RT
authors: Hui
authors: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China. Electronic address: huangxhong12@gmail.com.
authors: Xiao-Hong
authors: XH
authors: Huang
mesh_terms: D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood; D018450:Disease Progression; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006538:Heptanoic Acids / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use; D011804:Quinolines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D019821:Simvastatin / Q000627:therapeutic use; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D011804:Quinolines; D000069059:Atorvastatin; D019821:Simvastatin; C108475:pitavastatin
keywords: Heart failure; Lipophilic; Meta-analysis; Mortality; Statins