New findings that use of a statin dramatically reduces mortality due to advanced heart failure regardless of cause of condition or cholesterol level suggest this drug class may have a broad benefit for this seriously ill population, according to an article in the February 18th issue of the Journal of the American College of Cardiology.

In a first-of-its-kind study, investigators reviewed medical records for 551 patients with advanced heart failure (mean ejection fraction, 25 ± 7%) at one of the largest specialty programs in the US, recording whether or not each patient was given statin therapy. Both ischemic patients (those with heart failure due to a myocardial infarction) and non-ischemic patients (those with heart failure due to another cause) were included in the study. Currently, only about one third of American patients with heart failure are given a statin agent, usually to lower cholesterol and inhibit development and progression of atherosclerotic plaques.

“Our results were dramatic,” said Gregg Fonarow, MD principal investigator of the study and senior author. “We were surprised by the magnitude of the additional benefits of statins in patients who were already on standard medications to treat heart failure.”

According to Fonarow, no clinical trial data and very little research currently exist addressing the impact of cholesterol lowering medications on heart failure patients. Fonarow pointed out that some studies have suggested both potentially negative and positive effects of statins on this patient population, which convinced Fonarow and his team to launch a more comprehensive comparative study.

One year after initiation of statin therapy, non-ischemic patients on a statin had a 73 percent mortality reduction and ischemic patients had a 65 percent reduction. The results were independent of cholesterol levels, age, gender, medications, and other factors such as diabetes or coronary artery disease.

“If randomized clinical trials mirror our results, we may have a novel treatment for heart failure patients,” said Tamara Horwich, MD, lead author of the study. “The next step is to further study and understand the mechanisms by which statins may be improving survival in patients with heart failure.”

Fonarow noted that statins may prove to benefit heart failure patients in several areas, including reduction in inflammation, providing protective properties to help block dilation of the heart ventricles, and decreasing overactivity of the sympathetic nervous system. He added that the study also indicates the benefits of statins may outweigh any negative impact of these drugs, such as lowering cholesterol too far and reducing coenzyme Q10 levels.