Science + Technology

UCLA Study Shows Statin Medications May Markedly Improve Survival of Heart-Failure Patients


A new UCLA study shows the firstevidence that patients with heart failure may benefit from statin drugtreatment. The findings may lead to a novel treatment for the 5 millionAmericans who suffer from this life-threatening condition.

The new study, published in theFeb. 18 issue of the Journal of the American College of Cardiology,demonstrated that statin usage reduced the mortality rate of heart-failurepatients by 55 percent. Heart-failure patients benefited irrespective of thecause of their heart failure and their blood cholesterol levels. The studysuggests that statin usage may provide broad benefits to heart-failurepatients.

This is the first study of itskind. UCLA researchers analyzed medical records of heart‑failure patientsand compared mortality outcomes based on whether patients received statintreatment or not. Currently only one-third of heart-failure patients receivestatins, which typically are used to lower cholesterol and inhibit arteryplaque development.

"Our results were dramatic," saidDr. Gregg Fonarow, principal investigator and Eliot Corday Chair inCardiovascular Medicine and Science; professor of medicine, UCLA division ofcardiology; and director, Ahmanson-UCLA Cardiomyopathy Center. "We weresurprised by the magnitude of the additional benefits of statins in patientswho were already on standard medications to treat heart failure."

According to Fonarow, no clinicaltrial data and very little research currently exist addressing the impact ofcholesterol-lowering medications on heart-failure patients. Fonarow points outthat some studies have suggested both potentially negative and positive effectsof statins on this patient population, which convinced Fonarow and his team tolaunch a more comprehensive comparative study.

UCLA investigators reviewedmedical records of 551 patients at the Ahmanson-UCLA Cardiomyopathy Center, oneof the nation's largest heart-failure programs. Both ischemic patients (thosewith heart failure due to a heart attack) and non-ischemic patients (those withheart failure due to another cause such as hypertension or diabetes) wereincluded in the study.

Investigators found an overall 55percent reduction in mortality rate for heart-failure patients taking a statinat a one-year follow-up compared to patients not taking a statin drug.Non-ischemic patients taking a statin saw a 73 percent mortality reduction andischemic patients saw a 65 percent reduction. The results were independent ofcholesterol levels, age, gender, medications and other factors such as diabetesor coronary artery disease.

"If randomized clinical trialsmirror our results, we may have a novel treatment for heart‑failurepatients," said Dr. Tamara Horwich, first author and UCLA cardiology fellow."The next step is to further study and understand the mechanisms by whichstatins may be improving survival in patients with heart failure."

Fonarow notes that statins mayprove to benefit heart-failure patients in several areas, including reducinginflammation that plays a role in heart failure; offering protective propertiesto help block dilation of the heart ventricles, which progresses in heartfailure; and decreasing over-activity of the sympathetic nervous system thatoccurs in heart failure, which results in too much adrenaline that can harm theheart.

According to Fonarow, the UCLAstudy also indicates the benefits of statins may outweigh any negative impactof these drugs that some previous studies have suggested, such as loweringcholesterol too far and reducing coenzyme Q10 levels, which in heart-failurepatients may be harmful.

Heart failure or cardiomyopathyoccurs when the heart muscle has been damaged or weakened as a result ofcardiac conditions such as long-term high blood pressure, coronary arterydisease or a prior heart attack. The left ventricle becomes enlarged and theheart has to work much harder to pump blood to the rest of the body.

Each year, 500,000 newheart-failure patients are diagnosed in the United States and the economicburden of meeting the needs of this growing population is tremendous; theUnited States annually spends more on the medical care of heart-failurepatients than all cancers combined. The number of heart-failure patients isgrowing due to advances in treatments that are helping people to live longer.

The study was funded by theAhmanson-UCLA Cardiomyopathy Center.

Dr. W. Robb MacLellan, UCLAassociate professor of medicine, division of cardiology, is also an author ofthe study.



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