tailieunhanh - NEJM CARDIOVASCULAR DISEASE ARTICLES - Part 10

báo cáo một nghiên cứu đánh giá hiệu quả của 10 mg rosuvastatin hàng ngày ở bệnh nhân tim không ure và rối loạn chức năng tâm thu thất trái attri buted bệnh động mạch vành. | The new ENGLAND journal of medicine report on a study assessing the efficacy of 10 mg of rosuvastatin daily in patients with heart failure and left ventricular systolic dysfunction attributed to coronary artery disease. The study called the Controlled Rosuvastatin Multinational Trial in Heart Failure CORONA was a randomized placebo-controlled trial involving patients who were at least 60 years of age mean 73 years who were receiving high rates of evidence-based therapy for left ventricular systolic dysfunction including angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers and betablockers. As compared with placebo treatment with rosuvastatin resulted in no significant difference in the primary composite outcome of death from cardiovascular causes nonfatal myocardial infarction or nonfatal stroke even though the drug was associated with substantial reductions in levels of low-density lipoprotein LDL cholesterol and high-sensitivity C-reactive protein. Patients in the rosuvastatin group had significantly fewer hospitalizations for cardiovascular causes including heart failure rates of adverse drug events did not differ between the two study groups. Rosuvastatin therapy had no effect on the health status of patients as assessed on the basis of New York Heart Association class and the McMaster Overall Treatment Evaluation questionnaire which were designated as tertiary outcomes. Results aside one might ask whether a study of a statin for secondary prevention in this population was warranted. Although the numbers of patients with systolic heart failure who have been enrolled in previous secondary-prevention trials have been inadequate to generate robust evidence observational studies have suggested benefits of statin therapy on morbidity and mortality in this Statins also have a favorable effect on surrogate end points . endothelial function which in theory would be beneficial for patients with heart failure. Given these facts it .