Monday, December 11, 2006

Serum cholesterol, statins and heart failure

Is there a relationship between serum cholesterol level and prognosis following heart failure? Does lipid lowering have any effect on survival following CCF? I have posted earlier that the use of statins seems to improve the prognosis of CCF.

In the just ended AHA Annual Scientific Session in Chicago, Dr Periaswamy Velavan and investigators of Hull, UK, presented their work on the 12 weeks mortality of >5,000 patients with heart failure. True, this is very much a registry study and not a controlled trial. However, it does give important pointers regarding the relationhip of serum cholesterol and CCF survival.
In summary, they concluded from their study that too high a cholesterol (>200mg/dl), or too low (<150mg/dl) a cholesterol, was associated with poorer CCF prognosis. The relationship of serum cholesterol and heart failure survival, seemed to be U-shape. The other important fact that they reported was that the use of statins seemed to improve prognosis. How then do you reconcile these two findings?

It would seem that, like everything in nature, we must always do things in moderation. Too low or too high (the extremes) a cholesterol is bad. Taking statins may help improve prognosis of CCF but avoid high doses of powerful statins. Something moderate will do. As I noted in my last posting on this subject, there seem to be some anti-inflammatory effects of statins on the inflammatory component of CCF.

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