Statins and Heart Failure

Abstract

Heart failure (HF) is a major public health issue owing to its prognostic impact and high mortality rate. In the developed countries, the prevalence reaches 1-2% of the adult population, rising to over 10% in those over 70 years of age. 50-70% of patients with HF have hypercholesterolemia, and many do not achieve the therapeutic goals recommended by clinical practice guidelines. Although statin therapy has proved to have many cardiovascular benefits, patients with HF have been systematically excluded from clinical trials; thus, the use of statins in these patients remains controversial. Specifically in HF patients, two large studies with rosuvastatin (CORONA and GISSI-HF) and one with pitavastatin (PEARL) were conducted; no differences in mortality were observed, although pitavastatin therapy appeared to exert a beneficial effect in patients with left ventricular ejection fraction > 30%. The aim of this review was to provide an update on the role of statin therapy in the pathophysiology of HF and present the existing clinical trial data for statin use in HF.