Management of dyslipidaemia in patients with comorbidities-facing the challenge: heart failure

Area of Science:

• Cardiology
• Pharmacology
• Atherosclerosis Research

Background:

• Heart failure (HF) frequently co-occurs with coronary atherosclerosis, often with a causal link.
• Lipid-lowering drugs (LLDs) are commonly used for cardiovascular risk reduction.

Purpose of the Study:

• To review the efficacy of lipid-lowering drugs (LLDs) in patients with heart failure (HF) and coronary atherosclerosis.
• To evaluate LLDs for HF incidence and outcomes in HF patients.

Main Methods:

• Review of outcome trials involving specific LLDs like rosuvastatin and alirocumab in HF patients.
• Analysis of studies examining statin use in individuals without HF at baseline.
• Consideration of systemic inflammation and HF subtypes (ischemic vs. non-ischemic).

Main Results:

• Rosuvastatin and alirocumab trials in HF patients yielded neutral results, showing no benefit.
• Statin use in individuals without HF at baseline weakly but significantly reduced HF incidence.
• LLDs are not considered harmful in patients with HF.

Conclusions:

• LLDs demonstrate below-average efficacy in reducing hard cardiovascular endpoints in HF patients.
• Unlike comorbidities such as type 2 diabetes mellitus, HF shows limited benefit from LLDs regarding major cardiovascular events.