Interní Med. 2008; 10(5): 216-218

Is statine treatment in patients with heart failure effective?

prof. MUDr. Jaromír Hradec CSc., FESC

III. interní klinika VFN a 1. LF UK, Praha

Because of uncertainty about statine efficacy in patients with chronic heart failure and because of worries that statine treatment could be harmful in these patients a clinical trials CORONA was suggested and performed. Total of 5011 individuals with chronic heart failure of ischemic etiology older than 60 years in functional class NYHA II-IV were randomized to rosuvastatin in 10 mg dose daily or placebo. The primary aim of clinical efficacy was a combined endpoint of cardiovascular mortality and non fatal myocardial infarctions and strokes. Rosuvastatin in comparison to placebo decreased over the follow up time of 33 months plasmatic concentration of LDL cholesterol by 44% (p < 0.001) and concentration of high sensitive CRP (hsCRP) by 37,1 % (p < 0.001) but a combined clinical end point was not influenced by rosuvastatin. Its frequency decreased only by 8% which was not statistically significant (p = 0.12). Rosuvastatin did not influence significantly the incidence of all coronary events and overall mortality. However it lead to a decrease of frequency of cardiovascular hospitalisations (p < 0.001).Rosuvastatin was safe and there was no difference in frequency of myopathies and renal failure in comparison to placebo. There is no reason to add statine treatment to patients with chronic systolic heart failure to their current treatment, but there is also no reason to discontinue statines if they already take them (for example after a myocardial infarction).

Keywords: clinical trial CORONA, rosuvastatin, systolic heart failure, prognosis

Published: June 1, 2008  Show citation