Statin-Induced Low Cholesterol is Not Associated With Poor Outcome in Chronic Heart Failure

• Type: Article in International Scientific Journal
• Date: 2012

Authors

Sergio Silva (Author) Other; Patricia Lourenco (Author) Other; Cristiana Paulo (Author) Other; Ester Ferreira (Author) Other; Ana Lebreiro (Author) Other; Alexandra Sousa (Author) Other; Joana Mascaranhas (Author) Other; Marta Patacho (Author) Other; Jose Paulo Araujo (Author) FMUP; Paulo Bettencourt (Author) FMUP

Journal

Title: Journal of Cardiovascular Pharmacology and Therapeutics

Vol. 17

Pages: 284-290

ISSN: 1074-2484

Publisher: SAGE

Indexing

ISI Web of Knowledge - 10 Citations

Scopus - 10 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-002-6PJ

DOI: 10.1177/1074248411429967

Abstract (EN): Background: Low cholesterol levels are associated with a worse outcome in patients with heart failure (HF). Use of statins in HF remains controversial. We aimed to assess whether the prognosis of patients with intrinsically low cholesterol levels differed from that of those with pharmacologically induced low cholesterol. Materials and Methods: We conducted a retrospective cohort study on 464 ambulatory patients attending a specialized HF clinic. Patients were cross-classified according to statin therapy and admission total cholesterol level (low cholesterol <150 mg/dL and cholesterol >= 150 mg/dL): (1) low total cholesterol level on statin therapy; (2) low total cholesterol level not taking statins; (3) cholesterol >= 150 mg/dL on statin therapy; and (4) cholesterol >= 150 mg/dL not on statin therapy. Patients were followed up to 5 years and the outcome was all-cause death. A Cox regression analysis was used in prognosis assessment. Results: Almost two thirds of the patients were men and the median population age was 69 years; 22.8% of the patients had preserved ejection fraction and 43.5% severe systolic dysfunction. The patients with an intrinsically low cholesterol had a hazard ratio of all-cause death up to 5 years of 2.38 (1.08-7.14) compared to those with low cholesterol induced by statin use. This association was independent of other variables associated with outcome. Conclusions: Patients with HF with instrisically low cholesterol levels have a double risk of death up to 5 years compared to patients with pharmacologically induced low cholesterol. Clinicians should not limit the use of statins by fear of lowering the cholesterol levels.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7