Intensive Treatment with Atorvastatin in Patients with
Stable Coronary Artery Disease Significantly Reduces
Hospitalizations for Heart Failure (HF)
Statins
are known to reduce the rate of major cardiovascular events
through their lipid lowering effects, but their potential
benefit as treatment for HF is largely unexplored. Kiran K.
Khush et al from University of California, San Francisco
School of Medicine compared the effects of two doses of the
same statin formulation to determine their impact on the
incidence of hospitalization for HF among the two treatment
arms. This study, which was published in the February 6,
2007 issue of Circulation, found that intensive
treatment with atorvastatin in patients with stable coronary
artery disease significantly reduces subsequent
hospitalizations for HF compared with low-dose therapy. This
benefit was most pronounced in patients with a history of HF.
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Metoprolol Increases Plasma
Cardiac Natriuretic Peptide Levels in Patients
with Heart Failure
Many epidemiological
studies have shown β-blockers reduce mortality
in heart failure (HF). Consequently, β-blockade
is now standard therapy for symptomatic HF.
Acute and chronic HF prognosis is indicated, in
part, by measuring levels of the B-type cardiac
natriuretic peptides, brain natriuretic peptide
(BNP) and N-terminal pro brain natriuretic
peptide (NTproBNP). These biomarkers appear to
be good indicators of diagnosis and cardiac
function and have the potential to be useful for
cardiac diseases other than heart failure. A
study done by Mark E. Davis, MBChB et al from
the Christchurch School of Medicine and Health
Sciences in New Zealand reports that the
nonvasodilating β-blocker metoprolol causes a
rise in plasma BNP and NTproBNP in heart failure
patients that is unrelated to any clinical
deterioration. The study was published in the
February 13, 2006 issue of Circulation.
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Long-Term Vasodilator Therapy With
Nifedipine or Enalapril Did Not Reduce Need for Aortic-Valve
Replacement in Patients with Severe Aortic Regurgitation
Aortic regurgitation results in
left ventricular overload and eventual worsening of
function. Vasodilator’s, such as nifedipine or enalapril,
reduce both the afterload and the volume that regurgitates
into the left ventricular, thereby preserving left
ventricular function. It has been suggested that such
therapy may reduce the need for aortic-valve replacement. A
study by Artur Evangelista, M.D. et al from the Hospital
Universitai Vall d’Hebron in Barcelona, Spain identified
possible beneficial effects of vasodilator therapy on left
ventricular function and the need for aortic-valve
replacement. Their study, published in the September 29,
2005 issue of The New England Journal of Medicine showed
long-term vasodilator therapy did not reduce or delay the
need for aortic-valve replacement in patients with severe
aortic regurgitation.
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Higher Risk of
Sudden Death After Myocardial Infarction Among Patients with
Left Ventricular Dysfunction or Heart Failure
One of the most concerning complications of an acute myocardial
infarction (MI) is sudden death. The risk of sudden death is
greatest within a few hours after MI and decreases dramatically
thereafter. Scott D. Solomon, M.D., et al from the Brigham and
Women’s Hospital in Boston, MA studied the incidence and timing
of sudden unexpected deaths or cardiac arrests after MI in
patients with left ventricular dysfunction, heart failure or
both. Their study, published in the June 23, 2005 issue of The
New England Journal of Medicine shows that the risk of sudden
death is highest in the first 30 days after myocardial
infarction among patients with left ventricular dysfunction,
heart failure or both.
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Increased Risk of Mortality with Nesiritide for
Decompensated Heart Failure
Clinical Profile of Pregnancy-Associated Cardiomyopathy
Cardiac Resynchronization Improves Symptoms and Quality of
Life in Patients With Heart Failure and Cardiac
Dyssynchrony
Vitamin E Supplementation Does Not Improve Cardiovascular
Events and May Increase the Risk for Heart Failure
Glycogen
Storage Diseases Can Present as Hypertrophic
Cardiomyopathy
Implantable Cardioverter-Defibrillator Is More Effective
in Treating Congestive Heart Failure Than Amiodarone
Therapy
Heart
failure care inconsistent
A little
electrical boost may help many heart failure patients
ENABLE Results Show
Pitfalls of Endothelin Antagonists in Treating CHF
Resynchronization Therapy Reduces Hospitalization
Restoration Surgery May Have
Long-term Benefits for Heart Failure Patients
Isosorbide
Dinitrate and Hydralazine Combination Therapy Proves Beneficial
in Blacks with Heart Failure
