Are Statins Beneficial for Patients With Heart Failure?

There is a tremendous amount of evidence about the beneficial roles of statins, as related to primary and secondary prevention, for patients with ischemic heart disease. Many cardiologists are prescribing these drugs to their patients regardless of the left ventricular systolic function, and especially for patients with old myocardial infarction. After the report on the post-hoc analysis of the Scandinavian Simvastatin Survival Study, there have been many reports about the roles of statins for the patients with heart failure from ischemic or non-ischemic etiologies. But most of these reports were non-randomized, observational, post-hoc subgroup analyses and small prospective short term studies, and the power of the evidence was too weak to set a guideline for statin therapy in patients with heart failure. The conclusions of the previous reports were that two large prospective randomized trials might shed light on choosing to administer statins. Last November, the COntrolled ROsuvastatin multiNAtional trial in heart failure (CORONA) study was presented and many cardiologists believed that this study did not resolve the lack of evidence for the current practice of administering statins to heart failure patients with ischemic heart disease, but it proved the safety of administering 10 mg of rosuvastatin. So, we review the potential benefits of statins, beyond the cholesterol lowering effects in patients with heart failure, and we will reexamine the use of statins in patients with heart failure after the CORONA study. (Korean Circ J 2008; 38:185-190)