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Statins and chronic heart failure: do we need a large-scale outcome trial?

Henry Krum, MBBS, PhD, FRACP^*,* and John J. McMurray, MB, MD, FRCP, FACC, FESC

^* Monash University, Alfred Hospital, Melbourne, Australia
University of Glasgow, Glasgow, United Kingdom

View larger version (30K): [in a new window]   Figure 1 Effect of myocardial infarction and unstable angina on risk of death and of hospitalization for chronic heart failure (CHF) in the Studies Of Left Ventricular Dysfunction (5). RR = relative risk.

View larger version (47K): [in a new window]   Figure 2 Effect of pravastatin on coronary events in patients with coronary artery disease and a left ventricular ejection fraction (LVEF) of >0.40 enrolled in the Cholesterol And Recurrent Events trial (2). CHD = coronary heart disease. White bar = placebo; shaded bar = pravastatin.

View larger version (38K): [in a new window]   Figure 3 Effect of simvastatin on mortality among patients developing chronic heart failure (CHF) compared with those without clinical evidence of CHF in the Scandinavian Simvastatin Survival Study trial(1). White bar = placebo; shaded bar = simvastatin.

View larger version (21K): [in a new window]   Figure 4 The mevalonate-isoprene pathway.