Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Higashi-ku, Fukuoka, Japan.
J Cardiol. 2009 Jun;53(3):341-8. doi: 10.1016/j.jjcc.2008.12.002. Epub 2009 Feb 6.
Previous studies suggested that statins have pleiotropic effects, such as improvements in endothelial function, as well as anti-inflammatory, anti-proliferative, and anti-oxidative effects. These effects might benefit patients with heart failure. In those patients, statins relieved symptoms, decreased the frequency of hospitalization, suppressed neurohumoral activation, and improved cardiac function. However, it remains unknown how statins impact pathophysiology of heart failure with diabetes mellitus. The aim of this study was to investigate the effects of atorvastatin on pathophysiology of heart failure with diabetes mellitus.
We enrolled retrospectively 128 patients with heart failure with diabetes mellitus who were admitted from January 2003 to December 2005. Among these patients, 80 received atorvastatin (statin group) and the remaining patients served as controls (non-statin group). At study entry, there were no significant differences in the patient profiles between the two groups except for the low-density lipoprotein cholesterol level being higher in the statin group. After the follow-up period of two years, the frequency of re-hospitalization, brain natriuretic peptide, premature ventricular contractions, Lown grade, and deterioration of glomerular filtration rate were significantly less in the statin group.
Atorvastatin might benefit patients with heart failure and diabetes mellitus by improving ventricular electrical stability and decelerating deterioration of renal function.
既往研究提示他汀类药物具有多种作用，如改善内皮功能，以及抗炎、抗增殖和抗氧化作用。这些作用可能对心力衰竭患者有益。在这些患者中，他汀类药物可缓解症状、减少住院频率、抑制神经体液激活和改善心功能。然而，他汀类药物对糖尿病合并心力衰竭的病理生理学的影响仍不清楚。本研究旨在探讨阿托伐他汀对糖尿病合并心力衰竭患者病理生理学的影响。
我们回顾性纳入了 2003 年 1 月至 2005 年 12 月因心力衰竭住院的 128 例糖尿病患者。其中 80 例患者接受阿托伐他汀治疗（他汀组），其余患者作为对照组（非他汀组）。在研究开始时，两组患者的临床特征除他汀组的低密度脂蛋白胆固醇水平较高外，无明显差异。经过两年的随访，他汀组患者的再住院率、脑钠肽、室性早搏、Lown 分级和肾小球滤过率恶化程度均显著降低。
阿托伐他汀可能通过改善心室电稳定性和减缓肾功能恶化，对心力衰竭合并糖尿病患者有益。
