Key result
Statins reduce incident HF via pleiotropic actions but their role in established HF remains unclear.
Why the study?
Do statins reduce the incidence and progression of heart failure?
Do statins reduce the incidence and progression of heart failure?
This narrative review highlights that while statins may reduce the incidence of heart failure via pleiotropic effects, their benefit in patients with established heart failure remains unclear.
May support statins for HF prevention; leaves open their role in established disease pending trials.
BACKGROUND: Heart failure (HF) is characterized by cardiac functional and structural alterations, progressively leading to clinical symptoms and signs. Certain neurohormonal systems (i.e. the sympathetic nervous system, the reninangiotensin-aldosterone system and the natriuretic peptide system) as well as interactions between endothelial, monocytes/macrophages and myocardial cells are involved in the process. METHODS: The present narrative review discusses the relationships between lipids, statins and HF. RESULTS: Lipid metabolism is involved in cardiac function. Inflammation, oxidative stress, endothelial and platelet dysfunction, activation of neurohormonal systems, adverse cardiac remodeling, haemodynamic disorders and arrhythmogenesis predispose to HF development and progression. Statins have been shown to reduce HF incidence possibly via their pleiotropic actions on the above mentioned mechanisms. Other cardiovascular (CV) risk factors affecting HF prevalence and outcomes include metabolic syndrome, non-alcoholic fatty liver disease, chronic kidney disease, hyperuricaemia, epicardial fat and increased arterial stiffness that are improved following statin therapy. CONCLUSION: Lipid disorders are involved in HF development and progression. Statins may beneficially affect these disorders as well as other CV risk factors linked to HF. However, the impact of statins in patients with established HF has yet to be determined. Further studies are needed to unveil potential benefits of statin therapy (or some statins) in specific groups of HF patients.
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Katsiki et al. (2016) conducted a review in Heart failure. Statins was evaluated. Statins have been shown to reduce heart failure incidence via pleiotropic actions, though their impact in patients with established heart failure remains to be determined.
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