The influence of atorvastatin on parameters of inflammation and function of the left ventricle in patients with dilated cardiomyopathy
Agata Bielecka-Dabrowa, Jan Henryk Goch, Dimitri P. Mikhailidis, Jacek Rysz, Marek Maciejewski, Maciej Banach
Med Sci Monit 2009; 15(12): MS12-23
We assessed the influence of atorvastatin on selected indicators of an inflammation, function of the left ventricle and factors affecting the occurrence of rehospitalisation and mortality in patients with dilated cardiomyopathy (DCM).
Material and Method: In a prospective, randomized study, 68 patients with DCM with LVEF <or=40% were divided into 2 groups: group A consisted of 41 patients who were administered atorvastatin 40 mg/daily for 2 months and 10 mg for the next 4 months; and B consisted of 27 patients who were treated without statin therapy. Initial tests included the measurement of TNF-alpha, IL-6, IL-10, and NT-proBNP concentrations, echocardiographic examination and the assessment of exercise capacity in the 6-min walk test (6-MWT).
Results: In group A (vs group B), IL-6 was significantly lower (p<0.0001) after 2 months of treatment with atorvastatin. IL-6 and TNFalpha decreased significantly in group A, compared with initial values (p=0.0017 and p=0.0087, respectively). NT-proBNP was also significantly reduced in the atorvastatin group (p=0.0004), while in the control group an increase of NT-proBNP was observed (p=0.0021). After 6 months, the number of patients in NYHA class III was significantly decreased (from 47% to 22.5%) in group A, and the distance in 6-MWT considerably lengthened (p<0.05), while in group B the distance shortened significantly (p=0.0147). After 6 months, patients without statin treatment required more hospitalizations because of cardiac insufficiency (32% vs 12%, p=0.04).
Conclusions: Atorvastatin treatment significantly decreases the concentration of IL-6, and NT-proBNP in patients with DCM after 2 months of therapy. These results were consistent with the significant lengthening of the distance in 6-MWT, improvement of NYHA class, and fewer rehospitalizations due to heart failure, observed both after 2 and 6 months of atorvastatin treatment (ClinialTrial.gov No.: NCT01015144).
Keywords: Time Factors, Prospective Studies, Pyrroles - therapeutic use, Peptide Fragments - blood, Natriuretic Peptide, Brain - blood, Male, Middle Aged, Lipids - blood, Interleukin-6 - blood, Interleukin-10 - blood, Inflammation Mediators - blood, Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use, Humans, Heptanoic Acids - therapeutic use, Female, Exercise Test, Aged, Cardiomyopathy, Dilated - physiopathology, Tumor Necrosis Factor-alpha - blood, Ventricular Function, Left - drug effects