Statin therapy may lower mortality in heart failure patients

Cholesterol-lowering statin therapy may improve survival in patients with diastolic heart failure (DHF) according to a paper published in Circulation: Journal of the American Heart Association by cardiologists at Wake Forest University Baptist Medical Center.

Currently, there are no treatments shown to improve survival in these patients, who make up about 40 percent of all heart failure cases. Systolic heart failure patients have hearts that don’t pump out enough blood. In DHF, the heart does not fully relax and therefore does not fill properly with blood. The mortality rate is 5 to 8 percent per year.

William C. Little, M.D., head of the cardiology section at Wake Forest Baptist, and his research team found a dramatic difference in the longevity of 137 diastolic heart failure patients followed over a three-year period. The patients were being treated with ACE inhibitors, beta-blockers, calcium blockers or statins – all drugs that are commonly used to treat hypertension or heart-related conditions.

"Some patients in the group had been diagnosed with high cholesterol and placed on statin therapy by their doctors. Others in the group whose cholesterol levels were not as high in general, were not placed on statins," said Little. "But when we followed the patients we found that those who had received statins did dramatically better."

Little and his research team found that during the study period, heart failure patients on statin therapy had a risk of death that was 22 percent lower than the patients receiving the other drugs. Even after adjusting for other factors that could have affected the results, such as hypertension or cardiovascular disease, the heart failure patients on statins still fared better.

Little writes that the improved survival rates in the study might be due to the known beneficial effects of statins in patients with coronary artery disease. Whether diagnosed or not, coronary artery disease is quite common in the elderly population. Too, because diabetes and impaired kidney function are also common in patients with diastolic failure, statins may improve the outcome of these conditions, possibly explaining some of the benefits observed by his team with statins in diastolic heart failure.

"Because the patients were not randomized to which therapy they received, this is not a definitive study," said Little. "However, it certainly suggests that it’s worth looking into using statins to treat patients with diastolic heart failure."

According to previous reports in Circulation as well as the New England Journal of Medicine, diastolic heart failure is a significant healthcare problem. Once hospitalized, patients with diastolic heart failure have a 50 percent chance of rehospitalization within six months. It’s estimated that the cost of treating patients for diastolic heart failure exceeds $3.5 billion a year.

Co-authors of the report include Hidekatsu Fukuta, M.D. international research fellow, Nagoya Medical School, Japan, David C. Sane, M.D., associate professor of medicine, Wake Forest Baptist, and Steffen Brucks, M.D., international research fellow, University of Magdengurg, Germany.