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ASSA14-10-03 Atorvastatin for Coronary Heart Disease with Chronic Heart Failure in Chinese Population: A Meta-Analysis
  1. J Nan,
  2. J Huang,
  3. S Yang
  1. 9th Hospital of Peking University, Capital Medical University Affiliated Beijing Shijitan Hospital

Abstract

Objective To systematically assess the effectiveness of atorvastatin in Chinese patients with coronary heart disease (CHD) companied with chronic heart failure (CHF).

Methods Databases including PubMed, The Cochrane Library, EMbase, CNKI, CBM, and VIP were searched from inception to June 2014 to collect randomised controlled trials (RCTs) on atorvastatin for CHD with CHF. According to the inclusion criterion, relevant articles were screened. Then we extracted data, assessed quality, and performed meta-analysis using RevMan 5.3.

Results A total of 12 RCTs involving 1140 patients were included. The result of meta-analyses showed that compared with the control group at the 3–12 months after treatment, left ventricular ejection fraction (LVEF) elevated [MD = 7.98, 95% CI (6.42, 9.53), p < 0.0000 1], BNP decreased [MD = −95.72, 95% CI (−148.22, −48.22), p = 0.0004], LDL-C decreased[MD = −0.73, 95% CI(−0.96, −0.49), p < 0.0000 1], 6MWT increased[MD = 93.46, 95% CI(51.94, 134.97), p < 0.000 1], hsCRP decreased significantly [MD = −3.11, 95% CI(−4.68, −1.54), p = 0.000 1]. Further substudy reveal that atrovastain 20 mg group decrease hsCRP more significantly than 10 mg group [MD = −0.46, 95% CI(−0.71, −0.21), p = 0.003]. Atrovastain 40 mg group decreased LVEDD more significantly than atrovastain 20 mg group [MD = −6.87, 95% CI(−8.30, −5.45), p < 0.000 01]. Conclusion Current evidence indicates that atorvastatin, based on routine treatment, can increase LVEF and 6MWT, decrease BNP and reduce serum levels of inflammatory markers for patients with CHD with CHF. Further substudy revealed that high dose atrovastain might have a better treatment effect than low dose atrovastain. So atorvastatin is likely to be an effective drug, but it still has to be proved by large-scale and high-quality clinical trials.

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