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Current Clinical Pharmacology


ISSN (Print): 1574-8847
ISSN (Online): 2212-3938

Review Article

A Review of the Role of Statins in Heart Failure Treatment

Author(s): Massumeh Niazi, Nasrin Galehdar, Mohammad Jamshidi, Rasool Mohammadi and Alireza Moayyedkazemi*

Volume 15, Issue 1, 2020

Page: [30 - 37] Pages: 8

DOI: 10.2174/1574884714666190802125627


Background: Heart failure is a common medical problem in the world, which has a high prevalence in both developed and developing countries. Today, among the medications used for the heart failure treatment, there are many medications with a positive cardiac contraction effect (positive inotropic such as digital glycosides, adrenergic receptor stimulants, and phosphodiesterase inhibitors), a large number of cardiac diluents (such as Angiotensin-Converting Enzyme (ACE) inhibitor group), and a few other types of drugs whose final effects are still under review. Statins are valuable drugs that are broadly prescribed in hyperlipidemia and cardiovascular patients due to their multiple properties, such as cholesterol reduction, endothelial function improvement, antioxidative, anti-inflammatory, neovascularization, and immunomodulatory activities.

Methods: There is evidence that the therapeutic role of statins in HF, due to myocardial hypertrophy, show reduction in cardiomyocyte loss in the apoptosis process, oxidative stress, inflammation, and also the return of neurohormonal imbalance. However, the fact that these drugs have no sideeffects has not been confirmed in all studies, as statins prevent the production of particular beneficial and protective factors, such as coenzyme Q10 (CoQ10), while inhibiting the production of specific proteins involved in pathologic mechanisms.

Results: Recently, it has been hypothesized that, despite the positive effects reported, high doses of statins in patients with long-term heart failure lead to progress in heart failure by inhibiting CoQ10 synthesis and intensifying hypertrophy.

Conclusion: Thus, it can be stated that the advantage of using statins depends on factors, such as stroke fraction, and the existence of other standard indications such as atherosclerotic diseases or high Low-Density Lipoprotein-C (LDL-C).

Keywords: Heart failure, cardiovascular diseases, hypertension, cholesterol, enzyme, statin.

Graphical Abstract
Collins DRJ, Tompson AC, Onakpoya IJ, Roberts N, Ward AM, Heneghan CJ. Global cardiovascular risk assessment in the primary prevention of cardiovascular disease in adults: systematic review of systematic reviews. BMJ Open 2017; 7(3) e013650
[] [PMID: 28341688]
Divya A. A Short review on cardiovascular diseases. Res Rev: J Pharm Toxicol Stud 2016; 4(3): 165-70.
Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005; 352(16): 1685-95.
[] [PMID: 15843671]
Berezin.. Are endothelial cell-derived microparticles predictive biomarkers in cardiovascular diseases? Atheroscler open access 2016; 1 e101
Roger VL, Go AS, Lloyd-Jones DM, et al. Executive summary: heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation 2012; 125(1): 188-97.
[] [PMID: 22215894]
Inamdar AA, Inamdar AC. Heart failure: Diagnosis, management and utilization. J Clin Med 2016; 5(7): 62.
[] [PMID: 27367736]
Dassanayaka S, Jones SP. Recent developments in heart failure. Circ Res 2015; 117(7): e58-63.
[] [PMID: 26358111]
Huffman MD, Berry JD, Ning H, et al. Lifetime risk for heart failure among white and black Americans: cardiovascular lifetime risk pooling project. J Am Coll Cardiol 2013; 61(14): 1510-7.
[] [PMID: 23500287]
Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016; 37(27): 2129-200.
[] [PMID: 27206819]
Rogers C, Bush N. Heart failure: Pathophysiology, diagnosis, medical treatment guidelines, and nursing management. Nurs Clin North Am 2015; 50(4): 787-99.
[] [PMID: 26596665]
Jody RT, Alexander MC. Women with heart failure are at high psychosocial risk: A systematic review of how sex and gender influence heart failure self-care cardiology research and practice 2011; 47(8): 888-95.
Clark AM, Freydberg CN, McAlister FA, Tsuyuki RT, Armstrong PW, Strain LA. Patient and informal caregivers’ knowledge of heart failure: necessary but insufficient for effective self-care. Eur J Heart Fail 2009; 11(6): 617-21.
[] [PMID: 19414477]
Thomas J. Thom the heart Hurst’s volume. 19th ed. MG Graw-hill 1998; pp. 13-4.
Bello D, Shah NB, Edep ME, Tateo IM, Massie BM. Self-reported differences between cardiologists and heart failure specialists in the management of chronic heart failure. Am Heart J 1999; 138(1): 100-7.
Nasri H, Behradmanesh S, Maghsoudi AR, Ahmadi A, Nasri P, Rafieian-Kopaei M. Efficacy of supplementary vitamin D on improvement of glycemic parameters in patients with type 2 diabetes mellitus; a randomized double blind clinical trial. J Renal Inj Prev 2013; 3(1): 31-4.
[PMID: 25340161]
Mohamadnejad M, Al-Haddad MA, Moayyed KA, Eloubeidi MA. Biliary fascioliasis diagnosed by EUS. Gastrointest Endosc 2016; 83(3): 658-9.
[] [PMID: 26394385]
Denham NC, Pearman CM, Caldwell JL, et al. calcium in the pathophysiology of atrial fibrillation and heart failure. Front Physiol 2018; 9: 1380.
[] [PMID: 30337881]
Onwuanyi A, Taylor M. Acute decompensated heart failure: pathophysiology and treatment. Am J Cardiol 2007; 99(6B)(Suppl. 2): 25D-30D.
[] [PMID: 17378992]
Velli-peka H. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). Review Eur J Heart Fail 2017; 19: 821-36.
Borlaug BA. The pathophysiology of heart failure with preserved ejection fraction. Nat Rev Cardiol 2014; 11(9): 507-15.
[] [PMID: 24958077]
Lee DS, Gona P, Vasan RS, et al. Relation of disease pathogenesis and risk factors to heart failure with preserved or reduced ejection fraction: insights from the framingham heart study of the national heart, lung, and blood institute. Circulation 2009; 119(24): 3070-7.
[] [PMID: 19506115]
Ahmadi A, Mobasheri M, Soori H. Prevalence of major coronary heart disease risk factors in Iran. Int J Epidemiol Res 2014; 1(1): 3-6.
Multivalent feedback regulation of HMG CoA reductase, a control mechanism coordinating isoprenoid synthesis and cell growth. J Lipid Res 1980; 21(5): 505-17.
Brown MS, Goldstein JL. Multivalent feedback regulation of HMG CoA reductase, a control mechanism coordinating isoprenoid synthesis and cell growth. J Lipid Res 1980; 21(5): 505-17.
[PMID: 6995544]
Kelly JP, Dunning A, Schulte PJ, et al. Statins and exercise training response in heart failure patients: Insights from HF-action. JACC Heart Fail 2016; 4(8): 617-24.
[] [PMID: 27395348]
Taylor F, Huffman MD, Macedo AF, et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 2013; 2013(1) CD004816
[] [PMID: 23440795]
Bonsu KO, Kadirvelu A, Reidpath DD. Statins in heart failure: do we need another trial? Vasc Health Risk Manag 2013; 9: 303-19.
[PMID: 23807852]
Jiang SY, Li H, Tang JJ, et al. Discovery of a potent HMG-CoA reductase degrader that eliminates statin-induced reductase accumulation and lowers cholesterol. Nat Commun 2018; 9(1): 5138.
[] [PMID: 30510211]
Delahoy PJ, Magliano DJ, Webb K, Grobler M, Liew D. The relationship between reduction in low-density lipoprotein cholesterol by statins and reduction in risk of cardiovascular outcomes: an updated meta-analysis. Clin Ther 2009; 31(2): 236-44.
[] [PMID: 19302897]
Kazi DS, Penko JM, Bibbins-Domingo K. Statins for primary prevention of cardiovascular disease: Review of evidence and recommendations for clinical practice. Med Clin North Am 2017; 101(4): 689-99.
[] [PMID: 28577620]
Mahmoudvand H, Sepahvand A, Khatami M, Moayyedkazemi A. Prevalence and associated risk factors of Cystoisospora belli and Cyclospora cayetanensis infection among Iranian patients with colorectal cancer. J Parasit Dis 2019; 43(3): 402-5.
[] [PMID: 31406405]
Odden MC, Pletcher MJ, Coxson PG, et al. Cost-effectiveness and population impact of statins for primary prevention in adults aged 75 years or older in the United States. Ann Intern Med 2015; 162(8): 533-41.
[] [PMID: 25894023]
Logue J. AL-Ghibiwi H, Alamri AA, Preiss D. Systematic review of studies exploring reasons for statin non-adherence and of randomized controlled trials of interventions to improve adherence. Atherosclerosis 2015; 241(1) e52
Preiss D, Campbell RT, Murray HM, et al. The effect of statin therapy on heart failure events: A collaborative meta-analysis of unpublished data from major randomized trials. Eur Heart J 2015; 36(24): 1536-46.
Zilaee M, Ferns GA, Ghayour-Mobarhan M. Heat shock proteins and cardiovascular disease. Adv Clin Chem 2014; 64: 73-115.
[] [PMID: 24938017]
Willis MS, Patterson C. Hold me tight: Role of the heat shock protein family of chaperones in cardiac disease. Circulation 2010; 122(17): 1740-51.
[] [PMID: 20975010]
Forouzanfar F, Butler AE, Banach M, Barreto GE, Sahbekar A. Modulation of heat shock proteins by statins. Pharmacol Res 2018; 134: 134-44.
[] [PMID: 29935271]
Qin Y, Wang Y, Liu O, et al. tauroursodeoxycholic acid attenuates angiotensin ii induced abdominal aortic aneurysm formation in apolipoprotein e-deficient mice by inhibiting endoplasmic reticulum stress. Eur J Vasc Endovasc Surg 2017; 53(3): 337-45.
[] [PMID: 27889204]
Wang S, Kaufman RJ. The impact of the unfolded protein response on human disease. J Cell Biol 2012; 197(7): 857-67.
[] [PMID: 22733998]
Li Y, Lu G, Sun D, Zuo H, Wang DW, Yan J. Inhibition of endoplasmic reticulum stress signaling pathway: A new mechanism of statins to suppress the development of abdominal aortic aneurysm. PLoS One 2017; 12(4) e0174821
[] [PMID: 28369137]
Mollazadeh H, Atkin SL, Butler AE, Ruscica M, Sirtori CR, Sahebkar A. The effect of statin therapy on endoplasmic reticulum stress. Pharmacol Res 2018; 137(November): 150-8.
[] [PMID: 30312664]
Bielecka-Dabrowa A, Goch JH, Mikhailidis DP, Rysz J, Maciejewski M, Banach M. The influence of atorvastation on parameters of inflammation and function of the left ventricle in patients with dilated cardiomyopathy. Med Sci Monit 2009; 15(12): 12.
Mozaffarian D, Nye R, Levy WC. Statin therapy is associated with lower mortality among patients with severe heart failure. Am J Cardiol 2004; 93(9): 1124-9.
[] [PMID: 15110204]
Gastelurrutia P, Lupón J, de Antonio M, et al. Statins in heart failure: the paradox between large randomized clinical trials and real life. Mayo Clin Proc 2012; 87(6): 555-60.
[] [PMID: 22677075]
Lipinski MJ, Cauthen CA, Biondi-Zoccai GG, et al. Meta-analysis of randomized controlled trials of statins versus placebo in patients with heart failure. Am J Cardiol 2009; 104(12): 1708-16.
[] [PMID: 19962481]
Kjekshus J, Apetrei E, Barrios V, et al. Rosuvastatin in older patients with systolic heart failure. N Engl J Med 2007; 357(22): 2248-61.
[] [PMID: 17984166]
Bonsu KO, Reidpath DD, Kadirvelu A. effects of statin treatment on inflammation and cardiac function in heart failure: An adjusted indirect comparison meta-analysis of randomized trials. Cardiovasc Ther 2015; 33(6): 338-46.
[] [PMID: 26280110]
Mozaffarian D, Minami E, Letterer RA, Lawler RL, McDonald GB, Levy WC. The effects of atorvastatin (10 mg) on systemic inflammation in heart failure. Am J Cardiol 2005; 96(12): 1699-704.
[] [PMID: 16360360]
Dyrbuś K, Osadnik T, Desperak P, Desperak A, Gąsior M, Banach M. Evaluation of dyslipidaemia and the impact of hypolipidemic therapy on prognosis in high and very high risk patients through the Hyperlipidaemia Therapy in tERtiary Cardiological cEnTer (TERCET) Registry. Pharmacol Res 2018; 132: 204-10.
[] [PMID: 29258913]
Krum H, McMurray JJ. Statins and chronic heart failure: do we need a large-scale outcome trial? J Am Coll Cardiol 2002; 39(10): 1567-73.
[] [PMID: 12020481]
Böhm M, Hjalmarson A, Kjekshus J, Laufs U, McMurray J, van Veldhuisen DJ. Heart failure and statins--why do we need a clinical trial? Z Kardiol 2005; 94(4): 223-30.
[] [PMID: 15803258]
Horwich TB, Hamilton MA, Maclellan WR, Fonarow GC. Low serum total cholesterol is associated with marked increase in mortality in advanced heart failure. J Card Fail 2002; 8(4): 216-24.
[] [PMID: 12397569]
Miura S, Saku K. Effects of statin and lipoprotein metabolism in heart failure. J Cardiol 2010; 55(3): 287-90.
[] [PMID: 20350519]
Afsarmanesh N, Horwich TB, Fonarow GC. Total cholesterol levels and mortality risk in nonischemic systolic heart failure. Am Heart J 2006; 152(6): 1077-83.
[] [PMID: 17161056]
Tousoulis D, Charakida M, Stefanadi E, Siasos G, Latsios G, Stefanadis C. Statins in heart failure. Beyond the lipid lowering effect. Int J Cardiol 2007; 115(2): 144-50.
[] [PMID: 17175040]
Rosenfeldt F, Hilton D, Pepe S, Krum H. Systematic review of effect of coenzyme Q10 in physical exercise, hypertension and heart failure. Biofactors 2003; 18(1-4): 91-100.
[] [PMID: 14695924]
Okello E, Jiang X, Mohamed S, Zhao Q, Wang T. Combined statin/coenzyme Q10 as adjunctive treatment of chronic heart failure. Med Hypotheses 2009; 73(3): 306-8.
[] [PMID: 19409711]
Deichmann R, Lavie C, Andrews S. Coenzyme q10 and statin-induced mitochondrial dysfunction. Ochsner J 2010; 10(1): 16-21.
[PMID: 21603349]
Molyneux SL, Florkowski CM, George PM, et al. Coenzyme Q10: an independent predictor of mortality in chronic heart failure. J Am Coll Cardiol 2008; 52(18): 1435-41.
[] [PMID: 19017509]
Coenzyme Q. Coenzyme Q10 and statin-related myopathy. Drug Ther Bull 2015; 53(5): 54-6.
[] [PMID: 25977402]
Ayers J, Cook J, Koenig RA, Sisson EM, Dixon DL. Recent developments in the role of coenzyme Q10 for coronary heart disease: A systematic review. Curr Atheroscler Rep 2018; 20(6): 29.
[] [PMID: 29766349]

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