Cholesterol of the same heights ha...

Cholesterol of the same heights have been identified as a major risk factor for the evolution of coronary heart disease (CHD) This has l to multiple studies that have demonstrated the positive impact of 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) forward patients with CHD. Patients with CHD are at risk of developing chronic heart failure (CHF) single recent study showed that statin therapy can contract the risk of the progress to maturity of new-onset CHF in patients with CHD However, in theory, statin therapy in patients with established CHF may not be beneficial, and the mien of CHF has resulted in exclusion from the major statin studies. In addition, preliminary studies have intimateed that low cholesterol levels may be derived in an increased mortality rate in patients with CHF Rauchhaus and associates evaluated the relationship between cholesterol horizontal and survival in patients with CHF

The thought was divided into two parts: a derivation cogitation and a validation study. Investigators in the derivation cogitation recruited patients with CHF who had been diagnosed by the agency of established criteria and enrolled them in a metabolic close attention The validation study used a inferior independent population of outpatients with CHF Patients in the derivation dispose had a significant metabolic and cardiac assessment at baseline and were followed from one side of to the other time. Serum cholesterol levels were measured in the validation dispose during their routine care. Follow-up consisted of telephone calls to patients, their physicians, or between the sides of an information system. Survival status was determined by way of obtaining information from a national office of vital statistics. The primary result measure was all-cause mortality.

The derivation investigation involved 114 patients, while the validation thought included 303 patients. Survival in the derivation thought was 78 percent at 12 month and 56 percent at 36 month Increased total serum cholesterol plains in this group were predictors of survival independent of CHF etiology, age, left ventricular ejection fraction (LVEF) and exercise capacity. The best predictors for all-cause mortality were total serum cholesterol plains of 200.8 mg per dL (52 mmol by L) or less. In the validation application of mind the one-year survival rate was 88 percent and the three-year rate was 68 percent For each mmol by means of L incremental increase of total cholesterol in this population, there was a 25 percent increase in chance of survival. Lower cholesterol plains actually predicted a worse result independent of age, LVEF, recent York Heart Association classification, and peak oxygen consumption.

The authors terminate that low cholesterol levels in patients with CHF were associated independently with a worse prognosis. They caution that statin therapy in patients with CHF has not been well studied and that reducing cholesterol flats in these patients may cause more harm than useful They add that statins may have other beneficial tenors in patients with CHF, unless these effects need to be established [i]or[/i] part of to the other controlled trials.

Rauchhaus M et al. The relationship between cholesterol and survival in patients with chronic heart failure. J Am Coll Cardiol December 3 2003;42:1933-40

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