Abstract 12765: Atrorvastatin Prevents the Progression of Renal Dysfunction in Patietns with Chronic Heart Failure by Improvement in Cardiac Function and Anti-oxidative Effect - A Prospective Randomized Placebo-Controlled Study-
Background: Chronic heart failure (CHF) and renal dysfunction (RD) frequently coexist. Statins have pleiotropic effects such as anti-inflammatory, anti-oxidative, and vascular protective effects, which would be beneficial for patients (pts) with CHF and RD. Thus, we sought to investigate the effect of atorvastatin on renal function in CHF pts from the viewpoint of inflammation, oxidative stress and cardiac function.
Methods: We enrolled 38 mild to moderate CHF outpatients with LVEF<40% and serum creatinine < 3.0mg/dl. These pts were randomly assigned to receive atorvastatin (10mg/day) or placebo for 6 months in a double-blinded fashion. We measured serum creatinine level and calculated estimated Glomerular Filtration Rate (eGFR), and also measured LVEF and the circulating levels of Interleukin-6, high-sensitive CRP and oxidized low-density lipoprotein (oxLDL) as a maker of oxidative stress, before and after 6 months of treatment.
Results: There were no significant differences in age, gender, NYHA class, LVEF or eGFR at the entry between pts with atorvastatin (n=19) and placebo (control: n=19) administration. After 6 months of treatment, eGFR did not decrease in atorvastatin group (from 60.7±19.6 to 61.0±20.5 ml/min/1.73m2), while eGFR significantly decrease in placebo group (from 60.8±21.2 to 56.4±19.3ml/min/1.73m2, p<0.005). The depression of eGFR was significantly smaller in atorvastatin group than placebo group (-0.3±0.7 vs 4.4±5.3 ml/min/1.73m2, p<0.05). After 6 months of treatment, LVEF significantly increased in atorvastatin group (from 33.2±7.4% to 35.8±7.9%, p<0.05) but not in placebo group. Interleukin-6 and high-sensitive CRP tended to decrease in atorvastatin group after 6 months of treatment, although the change were not statistically significant (ANOVA, p=0.08). After 6 months of treatment, oxLDL significantly decreased in atorvastatin group (from 128±46 to 87±26 U/l, p<0.01) but not in placebo group. Furthermore, the change in eGFR significantly correlated with the change in LVEF (r=0.51, p<0.01) and oxLDL (r=-0.35, p<0.05) before and after 6 months of treatment.
Conclusion: Atorvastatin would prevent the worsening of renal function in CHF pts by improvement of LV function and reduction of oxidative stress.
- © 2012 by American Heart Association, Inc.