Effects of Statin Therapy on the Production of Monocyte Pro-Inflammatory Cytokines, Cardiac Function, and Long-Term Prognosis in Chronic Heart Failure Patients With Dyslipidemia

• Published in: Circulation Journal Vol. 76; no. 9; pp. 2130 - 2138
• Main Authors: Nakagomi, Akihiro, Seino, Yoshihiko, Kohashi, Keiichi, Kosugi, Munenori, Endoh, Yasumi, Kusama, Yoshiki, Atarashi, Hirotsugu, Mizuno, Kyoichi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2012
• Subjects: Aged; Chronic Disease; Cytokine; Dyslipidemia; Dyslipidemias - blood; Dyslipidemias - complications; Dyslipidemias - diagnosis; Dyslipidemias - drug therapy; Dyslipidemias - pathology; Dyslipidemias - physiopathology; Female; Heart failure; Heart Failure - blood; Heart Failure - complications; Heart Failure - diagnosis; Heart Failure - drug therapy; Heart Failure - pathology; Heart Failure - physiopathology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Inflammation Mediators - blood; Interleukin-6 - blood; Male; Middle Aged; Monocytes - metabolism; Monocytes - pathology; Prognosis; Statin; Stroke Volume; Tumor Necrosis Factor-alpha - blood
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-11-1123

Background: The effects of statin therapy on the production of monocyte pro-inflammatory cytokines, cardiac function and the long-term prognosis in chronic heart failure (CHF) patients with dyslipidemia remain unclear. Methods and Results: A total of 146 CHF patients with a mean left ventricular ejection fraction (LVEF) of 26.9±6.6% were divided into 2 groups based on whether or not statins were included in their treatment: a statin group (n=63) and a no statin group (n=83). Only patients with dyslipidemia were treated with statins. Peripheral blood mononuclear cells (PBMCs) were isolated, and the production of monocyte tumor necrosis factor (TNF)-α and interleukin (IL)-6 were measured at baseline and after 6 months of treatment, and the data expressed as mean±SD (pg·ml–1·10–6 PBMCs). The LVEF in the statin group improved, and the monocyte TNF-α and IL-6 production decreased (respectively, P<0.001), but the LVEF and cytokine production remained unchanged in the no statin group. Multivariate Cox hazard analysis showed that statin therapy (hazard ratio, 0.14; 95% confidence interval: 0.02–0.97, P=0.046) was an independent predictor of cardiac events. Conclusions: Statin therapy attenuates the production of monocyte pro-inflammatory cytokines, and ameliorates the cardiac function and may improve long-term prognosis in CHF patients with dyslipidemia.  (Circ J 2012; 76: 2130–2138)