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Statin Induced Regression of Cardiomyopathy Trial: A Randomized, Placebo-controlled Double-blind Trial
Ahmad Hersi1, J Peter Giannoccaro2, Andrew Howarth2
1Department of Cardiac Sciences, King Saud University Medical City, College of Medicine, Riyadh, Kingdom of Saudi Arabia.
Insights
Atorvastatin did not reduce left ventricular mass or improve diastolic function in patients with hypertrophic cardiomyopathy (HCM). This study found no benefit of atorvastatin for HCM patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertrophic cardiomyopathy (HCM) is a genetic heart disease characterized by myocardial thickening and fibrosis.
- HCM is a leading cause of sudden cardiac death in young adults.
Purpose of the Study:
- To investigate the potential of atorvastatin in inducing left ventricular (LV) mass regression in HCM patients.
- To assess the effect of atorvastatin on diastolic dysfunction in HCM.
Main Methods:
- The Statin Induced Regression of Cardiomyopathy Trial (SIRCAT) was a randomized, placebo-controlled study.
- 22 patients with HCM were randomized to receive atorvastatin 80 mg or placebo daily for 12 months.
- Primary endpoint: change in LV mass via cardiac magnetic resonance imaging. Secondary endpoint: diastolic function via echocardiography.
Main Results:
- No significant difference in LV mass regression between the atorvastatin and placebo groups after 12 months (P = 0.80).
- Atorvastatin did not improve echocardiographic indices of diastolic dysfunction, including transmitral flow velocities.
Conclusions:
- Atorvastatin treatment did not lead to LV mass regression in patients with HCM.
- Atorvastatin did not improve LV diastolic function in this patient cohort.
Background:
Hypertrophic cardiomyopathy (HCM), characterized by a thickened, fibrotic myocardium, remains the most common cause of sudden cardiac death in young adults. Based on animal and clinical data, we hypothesized that atorvastatin would induce left ventricular (LV) mass regression.
Methods:
Statin Induced Regression of Cardiomyopathy Trial (SIRCAT) was a randomized, placebo-controlled study. The primary endpoint was change in LV mass measured by cardiac magnetic resonance imaging 12 months after treatment with once-daily atorvastatin 80 mg or placebo. A key secondary endpoint was diastolic dysfunction measured echocardiographically by transmitral flow velocities. SIRCAT is registered with www.clinicaltrials.gov (NCT00317967).
Results:
Of 222 screened patients, 22 were randomized evenly to atorvastatin and placebo. The mean age was 47 ± 10 years, and 15 (68%) were male. All subjects completed the protocol. At baseline, LV masses were 197 ± 76 g and 205 ± 82 g in the placebo and atorvastatin groups, respectively. After 12 months treatment, the LV masses in the placebo and atorvastatin groups were 196 ± 80 versus 206 ± 92 g (P = 0.80), respectively. Echocardiographic indices were not different in the two groups at baseline. After 12 months, diastolic dysfunction as assessed using transmitral flow velocities E/E', A/A', and peak systolic mitral velocity showed no benefit from atorvastatin.
Conclusions:
In patients with HCM, atorvastatin did not cause LV mass regression or improvements in LV diastolic function.