Vaduganathan Muthiah, Greene Stephen J, Ambrosy Andrew P, Gheorghiade Mihai
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, GRB 740, Boston, MA, 02114, USA,
Heart Fail Rev. 2014 Nov;19(6):695-8. doi: 10.1007/s10741-014-9423-1.
Lower serum lipid levels are paradoxically predictive of poor clinical outcomes in hospitalized and ambulatory patients with heart failure (HF). In large randomized controlled trials, statins did not demonstrate an overall mortality benefit in chronic HF patients. We currently lack adequate prospective data that aggressive lipid management in HF truly alters disease course and progression. Despite their traditional use as lipid-lowering agents, hypothesis-generating works have suggested that statins may show benefit in specific enriched HF subgroups. Given that patients hospitalized for HF continue to face a high post-discharge event rate and that statins are increasingly inexpensive, widely available, and generally well tolerated, it is imperative that we identify those HF patients most likely to benefit and reconsider testing these agents in specific subpopulations.
矛盾的是，较低的血清脂质水平预示着住院和门诊心力衰竭（HF）患者的临床预后较差。在大型随机对照试验中，他汀类药物在慢性HF患者中未显示出总体死亡率获益。我们目前缺乏足够的前瞻性数据来证明在HF中积极进行脂质管理能真正改变疾病进程和进展。尽管他汀类药物传统上用作降脂药物，但产生假设的研究表明，他汀类药物可能在特定的富集HF亚组中显示出益处。鉴于因HF住院的患者出院后仍面临较高的事件发生率，且他汀类药物越来越便宜、广泛可得且通常耐受性良好，我们必须确定最可能受益的HF患者，并重新考虑在特定亚群中测试这些药物。
