Skip to main content

Effectiveness of Atorvastatin in the Treatment of Asymptomatic Heart Failure After Myocardial Infarction: A Clinical Study

Abstract

Introduction

Silent heart failure after myocardial infarction has not been effectively treated. Atorvastatin has certain efficacy in the treatment of heart failure. Our clinical study aimed to investigate the effectiveness of atorvastatin in patients with asymptomatic heart failure after myocardial infarction.

Methods

A total of 162 patients with asymptomatic heart failure after myocardial infarction in our hospital from August 2018 to August 2019 were randomly divided into the observation group (81 cases were treated with atorvastatin on the basis of routine therapy) and the control group (81 cases were treated with routine symptomatic treatment). The clinical curative effect, the level of related inflammatory cytokines, cardiac function index, and vascular endothelial function were compared between the two groups.

Results

Before intervention, there was no significant difference in tumor necrosis factor (TNFα), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), plasma N-terminal B-type natriuretic peptide (NT-ProBNP), left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular posterior wall thickness (LVPWT), asymmetric dimethyarginine (ADMA), activity of nitric oxide synthase (NOS), nitric oxide (NO) and flow-mediated dilation (FMD) between the two groups. After intervention, TNFα, hs-CRP, IL-6, NT-ProBNP, LVEF, LVEDD, LVESD, LVPWT, ADMA, NOS, NO, and FMD were improved in both groups. The clinical curative effect, TNFα, hs-CRP, IL-6, NT-ProBNP, LVEF, LVEDD, LVESD, LVPWT, ADMA, NOS, NO, and FMD in the observation group showed significantly greater results than those in the control group (P < 0.05).

Conclusion

Atorvastatin exerted a great effect in treating asymptomatic heart failure after myocardial infarction, which can evidently reduce the level of related inflammatory cytokines, improve cardiac function, and regulate vascular endothelial function. Hence, atorvastatin is considered a valid and alternative approach in clinical practice.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Drazner MH, Stevenson LW. Relief and prevention of congestion in heart failure enhance quality and length of life. Circulation. 2019;140(17):1380–2.

    Article  Google Scholar 

  2. Lyle MA, Iyer SR, Redfield MM, et al. Circulating neprilysin in patients with heart failure and preserved ejection fraction. JACC Heart Fail. 2020;8:70–80.

    Article  Google Scholar 

  3. Tastet L, Tribouilloy C, Marechaux S, et al. Staging cardiac damage in patients with asymptomatic aortic valve stenosis. J Am Coll Cardiol. 2019;74(4):550–63.

    Article  Google Scholar 

  4. Quan W, Zhang Z, Li P, et al. Role of regulatory T cells in atorvastatin induced absorption of chronic subdural hematoma in rats. Aging Dis. 2019;10(5):992–1002.

    Article  Google Scholar 

  5. Horwich TB, Maclellan WR. Atorvastatin and statins in the treatment of heart failure. Expert Opin Pharmacother. 2007;8(17):3061–8.

    CAS  Article  Google Scholar 

  6. Giahchi F, Mohammadi M. Reteplase versus streptokinase in management of ST-segment elevation myocardial infarction; a letter to the editor. Adv J Emerg Med. 2019;3(4):e34.

    PubMed  PubMed Central  Google Scholar 

  7. Pu Y, Wu D, Lu X, Yang L. Effects of GCN2/eIF2alpha on myocardial ischemia/hypoxia reperfusion and myocardial cells injury. Am J Transl Res. 2019;11(9):5586–98.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Al Aseri ZA, Habib SS, Marzouk A. Predictive value of high sensitivity C-reactive protein on progression to heart failure occurring after the first myocardial infarction. Vasc Health Risk Manage. 2019;15:221–7.

    CAS  Article  Google Scholar 

  9. Najjar F, Ahmad M, Lagace D, Leenen FHH. Role of myocardial infarction-induced neuroinflammation for depression-like behavior and heart failure in ovariectomized female rats. Neuroscience. 2019;415:201–14.

    CAS  Article  Google Scholar 

  10. Seki A, Patel S, Ashraf S, Perens G, Fishbein MC. Primary endocardial fibroelastosis: an underappreciated cause of cardiomyopathy in children. Cardiovasc Pathol. 2013;22(5):345–50.

    Article  Google Scholar 

  11. Palau P, Bertomeu-Gonzalez V, Sanchis J, et al. Differential prognostic impact of type 2 diabetes mellitus in women and men with heart failure with preserved ejection fraction. Rev Esp Cardiol (Engl Ed). 2020;73(6):463–70.

  12. Kong C, Zhou J, Ding W, et al. Antiproliferative effect and apoptosis of K562 cells induced by atorvastatin. Chongqing Med. 2018;47(3):299–301.

    Google Scholar 

  13. Owan T. Trends in prevalence and outcome of heart failure with preserved ejection fraction. N Engl J Med. 2006;355:251–9.

    CAS  Article  Google Scholar 

  14. Mcmurray JJV, Adamopoulos S, Anker SD, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart. Rev Espa Cardiol. 2012;66(4):328.

    Google Scholar 

  15. Ibrahim E, Magda M, Mohamed N, Walaa F, Ahmed A. Atorvastatin improves cardiac function and remodeling in chronic non-ischemic heart failure: a clinical and pre-clinical study. Egypt Heart J. 2015;67:289–98.

    Article  Google Scholar 

  16. Kociol RD, Horton JR, Fonarow GC, et al. Admission, discharge, or change in B-type natriuretic peptide and long-term outcomes: data from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF) linked to Medicare claims. Circ Heart Fail. 2011;4(5):628–36.

    CAS  Article  Google Scholar 

  17. Zheng J, Tang H, Jing L, Luo Q. Effect of Qishen Yiqi dropping pill combined with atorvastatin on cardiac function, BNP, TNF-α and IL-6 in patients with chronic heart failure. Chin J Clin. 2014;8(16):2972–5.

    Google Scholar 

  18. Ge X, Jin X. Effect of atorvastatin calcium on cardiac function and inflammatory factors in elderly patients with chronic heart failure. Chin J Gerontol. 2018;38(5):1058–60.

    Google Scholar 

  19. 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.

    CAS  Article  Google Scholar 

  20. Li Z (2018) Investigation on the clinical effect of atorvastatin in the treatment of coronary heart disease with heart failure and its influence on related indicators. Chin J Mod Drug Appl. 12:123–126

    Google Scholar 

  21. Peng H, Peng Z, Fan Z, et al. Effect of atorvastatin on vascular endothelial function in patients with chronic heart failure with different blood lipid levels. Chin J Gerontol. 2015;35(19):5486–7.

    CAS  Google Scholar 

  22. Chen F, Xu L, Zeng F, Qiu J. Effect of atorvastatin on left ventricular remodeling and cardiac function in patients with asymptomatic heart failure after myocardial infarction. Shandong Med J. 2015;40:46–7.

    CAS  Google Scholar 

  23. El-Sisi AA, Hegazy SK, Salem KA, AbdElkawy KS. Atorvastatin improves erectile dysfunction in patients initially irresponsive to sildenafil by the activation of endothelial nitric oxide synthase. Int J Impot Res. 2013;25:143–8.

    CAS  Article  Google Scholar 

  24. Young JM, Strey CH, George PM, et al. Effect of atorvastatin on plasma levels of asymmetric dimethylarginine in patients with non-ischaemic heart failure. Eur J Heart Fail. 2008;10(5):463–6.

    CAS  Article  Google Scholar 

  25. Huang J, Liu G, Yang H. Comparative study of different doses of atorvastatin in the treatment of asymptomatic heart failure after myocardial infarction. J Clin Med Pract. 2016;20(21):141–2.

    Google Scholar 

  26. Li G. Effects of different doses of atorvastatin on the changes of plasma APN and hs-CRP levels in patients with heart failure. Shaanxi Med J. 2013;42(1):61–3.

    Google Scholar 

Download references

Acknowledgements

We thank all participants in this study. Thank you to all the patients and their families who signed the consent.

Funding

No funding was received for the study or publication of this article.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Authorship Contributions

DW and XHY contributed to the conception and design of the study; LB and XRC performed the experiments, JDZ collected and analyzed data; DW and XHY wrote the manuscript; All authors reviewed and approved the final version of the manuscript.

Disclosures

Dong Wang, Long Bai, Xiao-Ran Cui, Xiao-Hong Yang and Ji-Dong Zhang have nothing to disclose.

Compliance with Ethics Guidelines

The study protocol was approved by the Ethics Committee of the Second Hospital of Hebei Medical University. Written informed consent was obtained from all the study subjects before enrollment. The study was performed in accordance with the declaration of Helsinki 1964 and its later amendments.

Data Availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Xiao-Hong Yang.

Additional information

Digital Features

To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12619592.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wang, D., Bai, L., Cui, XR. et al. Effectiveness of Atorvastatin in the Treatment of Asymptomatic Heart Failure After Myocardial Infarction: A Clinical Study. Adv Ther 37, 4649–4659 (2020). https://doi.org/10.1007/s12325-020-01441-8

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12325-020-01441-8

Keywords

  • Asymptomatic heart failure after myocardial infarction
  • Atorvastatin
  • Cardiac function
  • Clinical effect