Atorvastatin for Dilated Cardiomyopathy Complicating Chronic Heart Failure: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

KONG Xiangyong ¹ ,  HU Shilian ¹ , SHEN Gan ² , WU Lei ³ , XU Weiping ⁴ , CHEN Yin ⁵ , XU Tingjuan ⁵

1. Department of Gerontology, Anhui Provincial Hospital, Hefei 230001, China; 2. Cadre Ward, Anhui Provincial Level Committee Hospital, Hefei 230001, China; 3. Department of Neurology, Anhui Provincial Hospital, Hefei 230001, China; 4. Department of Pharmaceutical, Anhui Provincial Hospital, Hefei 230001, China; 5. Anhui Evidence-Based Medicine Center, Hefei 230001, China;

Corresponding author：

HU Shilian, Email: hushiliansy@yahoo.cn

Keywords：

Dilated cardiomyopathy; Atorvastatin; Heart failure; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20120190

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Objective 　To systematically assess the effectiveness and safety of atorvastatin in patients with dilated cardiomyopathy (DCM) complicating chronic heart failure (CHF).
Methods 　Databases including PubMed, The Cochrane Library, EMbase, CNKI, CBM, and VIP were searched from inception to November 2011 to collect randomized controlled trials (RCTs) on atorvastatin for DCM accompanied with CHF. According to the inclusion criterion, relevant articles were screened. Then we extracted data, assessed quality, and performed meta-analysis using RevMan 5.0.
Results 　A total of 11 RCTs involving 648 patients were included. The result of meta-analyses showed that compared with the control group at the sixth month after treatment, in the atorvastatin group, left ventricular ejection fraction (LVEF) obviously (MD=3.92, 95%CI 1.93 to 5.92, P=0.000 1) and 6-minute walk distance (MD=13.15, 95%CI 5.47 to 20.83, P=0.000 8) increased. Besides, serum level of CRP obviously decreased in the atorvastatin group (MD=1.91, 95%CI 3.03 to 0.79, P=0.000 9).
Conclusion 　Current evidence indicates that atorvastatin, based on routine treatment, can improve cardiac function to some extent, increase LVEF, and reduce serum levels of inflammatory markers for patients with DCM complicating CHF. Therefore, atorvastatin is likely to be a safe and effective drug for non-ischemic cardiomyopathy due to DCM, which still has to be proved by more large-scale and high-quality clinical trials.

Citation： KONG Xiangyong,HU Shilian,SHEN Gan,WU Lei,XU Weiping,CHEN Yin,XU Tingjuan. Atorvastatin for Dilated Cardiomyopathy Complicating Chronic Heart Failure: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2012, 12(10): 1223-1228. doi: 10.7507/1672-2531.20120190 Copy

1.	马文珠, 张寄南, 主编. 扩张型心肌病. 南京: 江苏科学技术出版社, 2000: 64-69.
2.	Richardson P, McKenna W, Bristow W, et al. Report of the 1995 World organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation, 1996, 93(12): 841-842.
3.	Go AS, Lee WY, Yang J, et al. Statin therapy and risks for death and hopitalization in chronic heart filure. JAMA, 2006, 296(17): 2105-2111.
4.	Goldberger J, Subacius H, Schaechter A, et al. Effects of statin therapy on arrhythmic events and survival in patients with nonischemic dilated cardiomyopathy. J Am Coll Cardiol, 2006, 48(6): 1228-1233.
5.	Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008.
6.	胡慧, 高毅滨, 郑文武. 阿托伐他汀对非缺血性心力衰竭患者心功能及内皮舒张功能影响的研究. 西部医学, 2011, 23(3): 425-427.
7.	刘扬. 阿托伐他汀对扩张型心肌病心功能及C反应蛋白和血浆脑钠肽的影响. 蚌埠医学院学报, 2011, 36(3): 258-262.
8.	殴荣华, 文书银, 邓小键. 阿托伐他汀对扩张型心肌病心力衰竭的影响研究. 医学信息, 2011, 3(2): 3905-3906.
9.	孙大英, 于凤秀. 阿托伐他汀对扩张型心肌病心力衰竭患者血清肝细胞生长因子水平的影响. 中国实用医药, 2008, 3(8): 64-66.
10.	乔延国, 黄志刚, 梁立武. 阿托伐他汀对扩张型心肌病伴慢性充血性心力衰竭患者心功能及预后的影响. 实用医学杂志, 2009, 25(10): 1590-1592.
11.	高毅滨, 胡慧, 郑文武. 阿托伐他汀治疗特发性扩张型心肌病伴心力衰竭的临床观察. 重庆医学, 2011, 40(5): 488-490.
12.	甘润韬, 李为民, 沈景霞, 等. 阿托伐他汀对扩张型心肌病患者细胞因子及心功能的影响. 中国综合临床, 2007, 23(8): 673-675.
13.	李泽林, 孙华保, 宁丹霞, 等. 阿托伐他汀对扩张型心肌病患者心功能及C-反应蛋白的影响. 现代医院, 2008, 8(7): 34-36.
14.	赵丽娜, 柳洪宙, 甄宇治, 等. 阿托伐他汀对扩张型心肌病心室重构和心功能的影响. 中国实用医药, 2008, 3(1): 11-13.
15.	Bleske BE, Nicklas JM, Bard RL et al. Neutral Effect on Markers of Heart Failure, Inflammation, Endothelial Activation and Function, and Vagal Tone After High-Dose HMG-CoA Reductase Inhibition in Non-Diabetic Patients With Non-Ischemic Cardiomyopathy and Average Low-Density Lipoprotein Level. J Am Coll Cardiol, 2006, 47(2): 338-341.
16.	Liu M, Wang F, Wang Y, et al. Atorvastatin improves endothelial function and cardiac performance in patients with dilated cardiomyopathy: the role of inflammation. Cardiovasc Drugs Ther, 2009, 23(5): 369-376.
17.	Node K, Fujita M, Kitakaze M, et al. Short-term statin therapy improves cardiac function and symptoms inpatients with idiopathic dilated cardiomyopathy. Circulation, 2003, 108(21): 839-843.
18.	Horwich TB, Hamilton MA, Maclellan WR, et al. Low serum total cholesterol is associated with marked increase in mortality in advanced Heart failure. J Card Fail, 2002, 8(5): 216-224.

1. 马文珠, 张寄南, 主编. 扩张型心肌病. 南京: 江苏科学技术出版社, 2000: 64-69.
2. Richardson P, McKenna W, Bristow W, et al. Report of the 1995 World organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation, 1996, 93(12): 841-842.
3. Go AS, Lee WY, Yang J, et al. Statin therapy and risks for death and hopitalization in chronic heart filure. JAMA, 2006, 296(17): 2105-2111.
4. Goldberger J, Subacius H, Schaechter A, et al. Effects of statin therapy on arrhythmic events and survival in patients with nonischemic dilated cardiomyopathy. J Am Coll Cardiol, 2006, 48(6): 1228-1233.
5. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated September 2008]. The Cochrane Collaboration, 2008.
6. 胡慧, 高毅滨, 郑文武. 阿托伐他汀对非缺血性心力衰竭患者心功能及内皮舒张功能影响的研究. 西部医学, 2011, 23(3): 425-427.
7. 刘扬. 阿托伐他汀对扩张型心肌病心功能及C反应蛋白和血浆脑钠肽的影响. 蚌埠医学院学报, 2011, 36(3): 258-262.
8. 殴荣华, 文书银, 邓小键. 阿托伐他汀对扩张型心肌病心力衰竭的影响研究. 医学信息, 2011, 3(2): 3905-3906.
9. 孙大英, 于凤秀. 阿托伐他汀对扩张型心肌病心力衰竭患者血清肝细胞生长因子水平的影响. 中国实用医药, 2008, 3(8): 64-66.
10. 乔延国, 黄志刚, 梁立武. 阿托伐他汀对扩张型心肌病伴慢性充血性心力衰竭患者心功能及预后的影响. 实用医学杂志, 2009, 25(10): 1590-1592.
11. 高毅滨, 胡慧, 郑文武. 阿托伐他汀治疗特发性扩张型心肌病伴心力衰竭的临床观察. 重庆医学, 2011, 40(5): 488-490.
12. 甘润韬, 李为民, 沈景霞, 等. 阿托伐他汀对扩张型心肌病患者细胞因子及心功能的影响. 中国综合临床, 2007, 23(8): 673-675.
13. 李泽林, 孙华保, 宁丹霞, 等. 阿托伐他汀对扩张型心肌病患者心功能及C-反应蛋白的影响. 现代医院, 2008, 8(7): 34-36.
14. 赵丽娜, 柳洪宙, 甄宇治, 等. 阿托伐他汀对扩张型心肌病心室重构和心功能的影响. 中国实用医药, 2008, 3(1): 11-13.
15. Bleske BE, Nicklas JM, Bard RL et al. Neutral Effect on Markers of Heart Failure, Inflammation, Endothelial Activation and Function, and Vagal Tone After High-Dose HMG-CoA Reductase Inhibition in Non-Diabetic Patients With Non-Ischemic Cardiomyopathy and Average Low-Density Lipoprotein Level. J Am Coll Cardiol, 2006, 47(2): 338-341.
16. Liu M, Wang F, Wang Y, et al. Atorvastatin improves endothelial function and cardiac performance in patients with dilated cardiomyopathy: the role of inflammation. Cardiovasc Drugs Ther, 2009, 23(5): 369-376.
17. Node K, Fujita M, Kitakaze M, et al. Short-term statin therapy improves cardiac function and symptoms inpatients with idiopathic dilated cardiomyopathy. Circulation, 2003, 108(21): 839-843.
18. Horwich TB, Hamilton MA, Maclellan WR, et al. Low serum total cholesterol is associated with marked increase in mortality in advanced Heart failure. J Card Fail, 2002, 8(5): 216-224.

Chinese Journal of Evidence-Based Medicine

Atorvastatin for Dilated Cardiomyopathy Complicating Chronic Heart Failure: A Meta-Analysis

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