Statin-Induced Low Cholesterol is Not Associated With Poor Outcome in Chronic Heart Failure
Journal of Cardiovascular Pharmacology and Therapeutics, 08/21/2012
Silva S et al. - Patients with heart failure (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.Methods
- The authors 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.
- 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.