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Heart failure and statins—Why do we need a clinical trial?

Herzinsuffizienz und Statine—Warum ist eine kontrollierte Studie notwendig?

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Zusammenfassung

Der Effekt einer Therapie mit Statinen auf die Morbidität und Sterblichkeit ist bei Patienten in der Sekundärund Primärprävention sowie bei Patienten mit akutem Koronarsyndrom gut belegt. Neuere Untersuchungen zeigten pleiotrope Effekte, die auch den Kardiomyozyten betreffen. Es gibt allerdings auch Hinweise, dass eine Senkung des LDL-Cholesterins zur Sterblichkeit bei schwerer Herzinsuffizienz in Beziehung steht. Darüber hinaus gibt es pleiotrope Effekte, die die Mitochondrienfunktion nachteilig beeinflussen könnten. Da es keine Sicherheitsdaten zur Verwendung von Statinen bei Patienten mit höhergradiger chronischer Herzinsuffizienz gibt, muss dringend eine randomisierte placebokontrollierte Studie durchgeführt werden.

Summary

The effect of statins to reduce mortality and morbiditiy in primary and secondary prevention as well as in acute coronary syndroms is well established. Recent data show that pleiotropic effects might also have direct effects on the myocardial cell. However, in chronic heart failure the outcome is inversely related to LDL-plasma concentrations and other pleiotropic effects might impair mitochondrial function. Since there are no safety data on the use of statins in chronic heart failure, a controlled randomized and placebo-controlled trial is urgently needed.

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Authors and Affiliations

  1. Klinik für Innere Medizin III, Universitätsklinik des Saarlandes, Kirrberger Straße, 66421, Homburg, Gemany

    M. Böhm & U. Laufs

  2. Sahlgrenska University Hospital, Divison of Cardiology, Gothenburg, Sweden

    A. Hjalmarson

  3. University of Oslo Rikshospitalet, Department of Cardiology, Oslo, Norway

    J. Kjekshus

  4. Gardiner Institute, Division of Cardiovascular Medicine, Western Infirmary, Glasgow, Scotland

    J. McMurray

  5. University Hospital Groningen, Department of Cardiology/Thoraxcenter, Groningen, The Netherlands

    D. J. van Veldhuisen

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  1. M. Böhm
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  2. A. Hjalmarson
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  3. J. Kjekshus
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  4. U. Laufs
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  5. J. McMurray
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  6. D. J. van Veldhuisen
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Correspondence to M. Böhm.

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Böhm, M., Hjalmarson, A., Kjekshus, J. et al. Heart failure and statins—Why do we need a clinical trial?. ZS Kardiologie 94, 223–230 (2005). https://doi.org/10.1007/s00392-005-0210-9

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  • DOI: https://doi.org/10.1007/s00392-005-0210-9

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