Effects of intensive versus mild lipid lowering by statins in patients with ischemic congestive heart failure: Korean Pitavastatin Heart Failure (SAPHIRE) study

Hae Young Lee, Hyun Jai Cho, Hee Yul Kim, Hee Kyung Jeon, Joon Han Shin, Suk Min Kang, Sang Hong Baek

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background/Aims: This study was designed to evaluate the dose-effect relationship of statins in patients with ischemic congestive heart failure (CHF), since the role of statins in CHF remains unclear.

Methods: The South koreAn Pitavastatin Heart FaIluRE (SAPHIRE) study was designed to randomize patients with ischemic CHF into daily treatments of 10 mg pravastatin or 4 mg pitavastatin.

Results: The low density lipoprotein cholesterol level decreased by 30% in the pitavastatin group compared with 12% in the pravastatin (p < 0.05) group. Left ventricular systolic dimensions decreased significantly by 9% in the pitavastatin group and by 5% in the pravastatin group. Left ventricular ejection fraction (EF) improved significantly from 37% to 42% in the pitavastatin group and from 35% to 39% in the pravastatin group. Although the extent of the EF change was greater in the pitavastatin group (16% vs. 11%) than that in the pravastatin group, no significant difference was observed between the groups (p = 0.386). Exercise capacity, evaluated by the 6-min walking test, improved significantly in the pravastatin group (p < 0.001), but no change was observed in the pitavastatin group (p = 0.371).

Conclusions: Very low dose/low potency pravastatin and high dose/high potency pitavastatin had a beneficial effect on cardiac reverse remodeling and improved systolic function in patients with ischemic CHF. However, only pravastatin significantly improved exercise capacity. These findings suggest that lowering cholesterol too much may not be beneficial for patients with CHF.

Original languageEnglish
Pages (from-to)754-763
Number of pages10
JournalKorean Journal of Internal Medicine
Volume29
Issue number6
DOIs
Publication statusPublished - 2014 Nov 1

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Pravastatin
Heart Failure
Lipids
Exercise
pitavastatin
Stroke Volume
LDL Cholesterol
Walking
Cholesterol

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Lee, Hae Young ; Cho, Hyun Jai ; Kim, Hee Yul ; Jeon, Hee Kyung ; Shin, Joon Han ; Kang, Suk Min ; Baek, Sang Hong. / Effects of intensive versus mild lipid lowering by statins in patients with ischemic congestive heart failure : Korean Pitavastatin Heart Failure (SAPHIRE) study. In: Korean Journal of Internal Medicine. 2014 ; Vol. 29, No. 6. pp. 754-763.
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abstract = "Background/Aims: This study was designed to evaluate the dose-effect relationship of statins in patients with ischemic congestive heart failure (CHF), since the role of statins in CHF remains unclear.Methods: The South koreAn Pitavastatin Heart FaIluRE (SAPHIRE) study was designed to randomize patients with ischemic CHF into daily treatments of 10 mg pravastatin or 4 mg pitavastatin.Results: The low density lipoprotein cholesterol level decreased by 30{\%} in the pitavastatin group compared with 12{\%} in the pravastatin (p < 0.05) group. Left ventricular systolic dimensions decreased significantly by 9{\%} in the pitavastatin group and by 5{\%} in the pravastatin group. Left ventricular ejection fraction (EF) improved significantly from 37{\%} to 42{\%} in the pitavastatin group and from 35{\%} to 39{\%} in the pravastatin group. Although the extent of the EF change was greater in the pitavastatin group (16{\%} vs. 11{\%}) than that in the pravastatin group, no significant difference was observed between the groups (p = 0.386). Exercise capacity, evaluated by the 6-min walking test, improved significantly in the pravastatin group (p < 0.001), but no change was observed in the pitavastatin group (p = 0.371).Conclusions: Very low dose/low potency pravastatin and high dose/high potency pitavastatin had a beneficial effect on cardiac reverse remodeling and improved systolic function in patients with ischemic CHF. However, only pravastatin significantly improved exercise capacity. These findings suggest that lowering cholesterol too much may not be beneficial for patients with CHF.",
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Effects of intensive versus mild lipid lowering by statins in patients with ischemic congestive heart failure : Korean Pitavastatin Heart Failure (SAPHIRE) study. / Lee, Hae Young; Cho, Hyun Jai; Kim, Hee Yul; Jeon, Hee Kyung; Shin, Joon Han; Kang, Suk Min; Baek, Sang Hong.

In: Korean Journal of Internal Medicine, Vol. 29, No. 6, 01.11.2014, p. 754-763.

Research output: Contribution to journalArticle

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T1 - Effects of intensive versus mild lipid lowering by statins in patients with ischemic congestive heart failure

T2 - Korean Pitavastatin Heart Failure (SAPHIRE) study

AU - Lee, Hae Young

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AU - Kim, Hee Yul

AU - Jeon, Hee Kyung

AU - Shin, Joon Han

AU - Kang, Suk Min

AU - Baek, Sang Hong

PY - 2014/11/1

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N2 - Background/Aims: This study was designed to evaluate the dose-effect relationship of statins in patients with ischemic congestive heart failure (CHF), since the role of statins in CHF remains unclear.Methods: The South koreAn Pitavastatin Heart FaIluRE (SAPHIRE) study was designed to randomize patients with ischemic CHF into daily treatments of 10 mg pravastatin or 4 mg pitavastatin.Results: The low density lipoprotein cholesterol level decreased by 30% in the pitavastatin group compared with 12% in the pravastatin (p < 0.05) group. Left ventricular systolic dimensions decreased significantly by 9% in the pitavastatin group and by 5% in the pravastatin group. Left ventricular ejection fraction (EF) improved significantly from 37% to 42% in the pitavastatin group and from 35% to 39% in the pravastatin group. Although the extent of the EF change was greater in the pitavastatin group (16% vs. 11%) than that in the pravastatin group, no significant difference was observed between the groups (p = 0.386). Exercise capacity, evaluated by the 6-min walking test, improved significantly in the pravastatin group (p < 0.001), but no change was observed in the pitavastatin group (p = 0.371).Conclusions: Very low dose/low potency pravastatin and high dose/high potency pitavastatin had a beneficial effect on cardiac reverse remodeling and improved systolic function in patients with ischemic CHF. However, only pravastatin significantly improved exercise capacity. These findings suggest that lowering cholesterol too much may not be beneficial for patients with CHF.

AB - Background/Aims: This study was designed to evaluate the dose-effect relationship of statins in patients with ischemic congestive heart failure (CHF), since the role of statins in CHF remains unclear.Methods: The South koreAn Pitavastatin Heart FaIluRE (SAPHIRE) study was designed to randomize patients with ischemic CHF into daily treatments of 10 mg pravastatin or 4 mg pitavastatin.Results: The low density lipoprotein cholesterol level decreased by 30% in the pitavastatin group compared with 12% in the pravastatin (p < 0.05) group. Left ventricular systolic dimensions decreased significantly by 9% in the pitavastatin group and by 5% in the pravastatin group. Left ventricular ejection fraction (EF) improved significantly from 37% to 42% in the pitavastatin group and from 35% to 39% in the pravastatin group. Although the extent of the EF change was greater in the pitavastatin group (16% vs. 11%) than that in the pravastatin group, no significant difference was observed between the groups (p = 0.386). Exercise capacity, evaluated by the 6-min walking test, improved significantly in the pravastatin group (p < 0.001), but no change was observed in the pitavastatin group (p = 0.371).Conclusions: Very low dose/low potency pravastatin and high dose/high potency pitavastatin had a beneficial effect on cardiac reverse remodeling and improved systolic function in patients with ischemic CHF. However, only pravastatin significantly improved exercise capacity. These findings suggest that lowering cholesterol too much may not be beneficial for patients with CHF.

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